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Case Presentation; Hx 34 y/o male A history of intermittent

LBP & leg pain for 6m Recent severe pain in legs Recent severe pain in legs

especially in walking for 5d

Paresthesis on the Lt 5th

toe

What do you do?

Page 3: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Case Presentation; Ph/Ex

Limited left SLR (<20 deg) No significant muscle weakness Symmetrical DTRSymmetrical DTR Obvious trunk shift clinically

What do you do?

Page 4: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Plain Rx

Page 5: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

MRI

What do you do?

Page 6: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

F/U >6w-3mNSAIDs, AnalgesicsAggressive PTHydrotherapyHydrotherapyModifications in life styleEpidural injection….

Page 7: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Surgery

Case Presentation; Hx

57 y/o male A history of Axial pain

including LBP for 8m

Complained from disability in walking

What do you do?

Page 10: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Case Presentation; Ph/Ex Normal SLR Achilles DTR: Left +1 Right +2 Patellar DTR: Left +2 Right +3Patellar DTR: Left +2 Right +3 Rt BTE: 4/5 Diffuse paresthesis, No clonus ….

What do you do?

Page 11: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Requested Plain Rx

What do you do?

Page 12: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Requested MRI

What do youdo?

Page 13: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Page 14: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Page 15: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

Page 16: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

40m after operation

Page 17: Case Presentation; Hx · Case Presentation; Hx 34 y/o male A history of intermittent LBP & leg pain for 6m Recent severe pain in legs especially in walking for 5d Paresthesis on the

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