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Spinal Case Study Library

Each of our cases provides a patient's history, exam and imaging, treatment, outcome and peer discussion.
Cast your vote for treatment and share in the case discussions.

Diffuse Idiopathic Skeletal Hyperostosis (DISH) Causing Dysphagia

Presented by:
K. Daniel Riew, M.D.

A 60-year-old male presents with progressive dysphagia. He has no neck pain but notes a limitation of his range of motion.

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Progressive Pseudoclaudication in an Elderly Man

Presented by:
James D. Schwender, MD

This 72-year-old man presented with progressive pseudoclaudication. His ability to walk is limited to 100 yards. Bilateral L3 radiculopathy was confirmed with EMG.

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Woman with Ankylosing Spondylitis

Deformity Makes It Difficult to Look People in the Eye

Presented by:
Stephen Lewis, MD

The patient is a 66-year-old female with ankylosing spondylitis who independently ambulates without any aids. Her deformity makes horizonal gaze difficult. How would you approach treatment, and what risks are involved?

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Former Professional Lacrosse Player Presents with Right Arm Pain and Triceps Weakness

No Evidence of Myelopathy

Presented by:
Todd Albert, MD

Spine Case: Former professional lacrosse player in s/p C3-7 laminectomy without fusion (10 years prior) and C5-6 ACDF (5 years prior) for myelopathy presents with right arm pain and severe right triceps weakness. Vote on your preferred treatment.

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Harrington Hook in Canal: Woman with Previous Surgery Presents with Low Back Pain and Neuroclaudication

Presented by:
Stephen Lewis, MD

The patient is a 35-year-old woman who had a Harrington rod implanted at age 14 for idiopathic scoliosis. She presented with low back pain and neuroclaudication. How would you treat her?

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Unsteady Gait and Pain in Upper Limbs: Which Approach Is Best?

Presented by:
Michael G. Fehlings, MD

Spine case presented by Michael G. Fehlings, MD: a 61-year-old male autoworker has progressively worsening gait, motor dysfunction, and pain in upper limbs. How would you treat this?

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Elderly Woman with Progressive Difficulty Walking

Do You Operate?

Presented by:
Mick J. Perez-Cruet, MD

Vote for your treatment preference in this spine case: 91-year-old woman presents with one-year history of gradually progressive difficulty walking.

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Recurrent Myelopathy and Adjacent Segment Disease

Myelopathy Returns 3 Years After Surgery

Presented by:
Paul C. McCormick, MD, MPH, FACS

What do you do with a patient with recurrent cervical myelopathy? Case from Paul C. McCormick, MD, demonstrating treatment strategy for this dilemma.

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Nun with Progressive Deformity: Fuse or Not Fuse?

Presented by:
Keith Bridwell, MD

The patient is a 24-year-old nun who presents with progressive deformity. She says she had a 45° right thoracic curve at age 17. She has more back pain than 5 years ago, but it is not excruciating.

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Severe Back Pain with Radiation Around Right Abdomen

Presented by:
Richard G. Fessler, MD, PhD

Spine case from Richard G. Fessler, MD, PhD, a neurosurgeon: The patient is a 39-year-old male who presents with severe back pain that radiates around right abdomen to just below the navel.

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