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

Gaetano J. Scuderi, M.D. Jupiter Medical Center Jupiter, FL

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

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