The Lumbar Spine: A Herniated Disc - Perhaps Not So Simple Case - PowerPoint PPT Presentation

The Lumbar Spine: A Herniated Disc - Perhaps Not So Simple Case Presentation Gaetano J. Scuderi, M.D. Jupiter Medical Center Jupiter, FL

Case Report • 63 year-old orthopedic surgeon • Long history of LBP • Bilateral un-instrumented fusion for CLBP in 1984 • Bilateral thigh pain in the back esp. when hyperextends • Can’t sit, doesn’t drive, sits in the passenger side and reclines. • Leg and thigh pain, occasional numbness

X-rays

MRI

Lumbar HNP Mark F. Kurd, MD Associate Professor, Department of Orthopaedics Thomas Jefferson University The Rothman Institute

• 37 yo male • Symptoms – Six months R leg pain, numbness – Worse with sitting, can’t drive to work – Subjective weakness • Tx: – PT, ESI, pain medication • PE: – 4/5 R EHL – Dec sensation R L5 – Pos R SLR