Here we present challenging spine cases, including history,
physical exam, and images. We then suggest various treatment options
and ask for your suggested treatment.
SpineUniverse Professional / Spinal Case Studies


Significant Back and Leg Pain in a 70-Year-old Female
By: Timothy R. Kuklo, MD, JD
A 70-year-old female presents with significant back and leg pain. Overall, her sagittal imbalance is fair and she is unable to maintain posture.
Progressive Back Pain in a 26-Year-old Male
By: Jeffrey C. Wang, MD
This 26-year-old male, who previously underwent discectomy for radicular leg pain, now presents with progressive back pain.
Adult Scoliosis: Progressive Lower Extremity Radicular Pain
By: Christopher I. Shaffrey, MD
The patient is a 44-year-old female diagnosed with adjacent segment degeneration after prior Harrington rod treatment.
Gait and Balance Difficulties in a 76-Year-old Male
By: Richard G. Fessler, MD, PhD
The patient is a 76-year-old male whose gait is broad-based and unsteady; he cannot tandem walk.
Cervical Degenerative Disease
By: Richard G. Fessler, MD, PhD
This 67-year-old male presented with neck pain with mild radiation into both shoulders. He had slight difficulty with tandem gait.
Lumbar Herniation with Radiculopathy
By: Timothy R. Kuklo, MD, JD
Presenting with a 10-week history of left leg and back pain, this 42-year-old male described his pain as posterior left thigh, calf, and ankle.
Intractable Chronic Pain in Patient with Post-laminectomy (Failed Back Surgery)
By: Leonardo Kapural, MD, PhD
Jennifer Ferreira, PA-C, MPAS
The patient is a 51-year-old lae who presents with lumbar and leg pain secondary to lumbosacral neuritis and post-laminectomy (failed back surgery) syndrome.
Increasing Back and Leg Pain, Quadricep Weakness
By: Timothy R. Kuklo, MD, JD
This older patient presented with a 4-year history of increasing back and severe leg pain with bilateral quacricep weakness.
Cervical Trauma in a Young Football Player
By: Christopher I. Shaffrey, MD
This 16-year-old football player presents with severe neck pain and transient quadriparesis following a tackle.
Grade IV Ismthic Spondylolisthesis
By: Christopher I. Shaffrey, MD
The patient is a 32-year-old who underwent in situ fusion for grade II spondylolisthesis at age 16. She now presents with increasing low back pain with radiculopathy.
Cervical Degenerative Changes with Segmental Kyphosis
By: Marc A. Weinstein, MD
The 44-year-old's cervical radiographs indicate degenerative changes and loss of disc space with segmental kyphosis.
Spontaneous Low Back Pain, Radiculopathy and Weakness in a 28-Year-old
By: Faisel M. Zaman, MD, FAAPMR, ABPM
Periodic flare-up of low back pain in the past was resolved with abdominal exercises, which now hurt instead of help.
Bilateral L2 Spondylolysis: Nonsurgical or Surgical Treatment?
By: Michael P. Schaefer, MD
This 29-year-old former college football player presented with sharp stabbing pain in the upper lumbar spine.
Cervical Radiculopathy: Classic Case?
By: Richard G. Fessler, MD, PhD
The patient is a 45-year-old male with a 3-month history of neck, shoulder and arm pain.
High-speed Motor Vehicle Accident: 24-Year-old
By: Alexander R. Vaccaro, MD, PhD
D. Greg Anderson
, MD
The patient is a 24-year-old woman, who was a rear passenger (properly restrained) in a high-speed motor vehicle accident.
Cervical Spondylotic Myelopathy with Cord Compression
By: Faisel S. Taleb, MD, FRCSI
A case involving progressive cervical myelopathy with pannus at C1-C2 level with significant cord compression and subaxial spondylosis with cord compression.
Growing Spine Case: 5-Year-old with Increasing Spinal Deformity
By: Charles E. Johnston, MD
A 5-year-old male, with an uncharacterized congenital myopathy, presented for increasing spinal deformity.
Unusual Case: Low Back Pain with L1-L3 Degeneration and L1-L2 Instability
By: Iqbal Shabir Khan, MD
This is an unusual case of a 30-year-old male diagnosed with SAPHO.
Lumbar Radicular Symptoms in a 24-Year-old Male
By: Mitchell A Hardenbrook*, MD
A 24-year-old male with back pain that radiates to the left buttock, leg and great toe, rates his pain at 7/10.
Discitis and Osteomyelitis in a 63-Year-old Male
By: Choll W. Kim, MD, PhD
During the course of treatment, this 63-year-old man developed severe low back pain, recurrent fevers, and intermittent bacteremia.
Cervical Degenerative Disc Disease: 34-Year-old Male
By: Michael G. Kaiser, M.D.
This relatively young man (34-years-old) is diagnosed with cervical spondylotic myelopathy with associated left C7 radiculopathy.
Competitive Equestrienne: Incapacitating Low Back Pain
By: Richard G. Fessler, MD, PhD
Case about a 32-year-old female equestrienne with incapacitating low back pain unresponsive to non-surgical care.
Burst Fracture in a 79-Year-old Male: How would you treat?
By: Jason M. Highsmith, MD
This case is about a 79-year-old man whose fall caused an L1 burst fracture. Case details, treatment, and discussion included.
16-Year-old with Grade 3 Spondylolisthesis
By: Timothy R. Kuklo, MD, JD
This case study details treatment of a 16-year-old female with a grade 3 spondylolisthesis.
L1 Burst Fracture: Bracing or Surgery?
By: Lali Sekhon, MD, PhD, FRACS, FICS
The 55-year-old patient suffered an L1 burst fracture in an ATV accident.
Cervical Chondrosarcoma
By: Daniel K. Park, MD
Primary chondrosarcoma is a rare condition and few reports exist beyond this case. During the period between 1916 to 1981, only 37 patients who presented at the Mayo Clinic had spinal chondrosarcomas
Adolescent Disc Herniation: Conservative or surgical treatment?
By: Reginald Q. Knight, MD
A 17-year-old male soccer player, who landed awkwardly during a game, presented with a 6-month history of increasing low back and buttock pain. Presented is the patient's history, physical exam, diag
Severe Low Back Pain in a 90-Year Old Male
By: Steven Richeimer, MD
The patient is a 90-year-old male with a long history of intermittent low back pain that was well-controlled for years after a L3-L5 laminectomy. During the past 9-months, the patient’s low...
Adjacent Segment Degeneration after Previous Decompression and Fusion
By: David W. Polly, Jr., MD
The patient is a 59 year-old male, non-smoker, and of acceptable weight level. The patient presented in 2006 with severe, “unacceptable” low back pain, and early fatigue marked by diminished...
Degenerative Disc Disease in a 30 Year-old Female
By: David W. Polly, Jr., MD
This 30 year-old female presented with low back pain that started 6 months ago. Activity makes her pain worse. She reports back pain as 8/10 and thigh pain as 5/10 without pain distal to the...
Cervical Pseudoarthrosis and Adjacent Level Disease
By: Jason M. Highsmith, MD
This 70 year-old female presented reporting increasing neck and periscapular pain over several years. The patient underwent a C5-C7 ACDF 11 years earlier. Her pain intensified and radiated...
Adult Onset Scoliosis
By: Amir A. Mehbod, MD
The patient is a 31-year-old male with back and right lower extremity pain.  His pain started 6 months ago and is unrelated to trauma.  He feels the pain is 20% back-related and 80%...
Reactive Scoliosis
By: Amir A. Mehbod, MD
The patient is a 13-year-old male who feels mid-thoracic pain. An active junior high student who enjoys playing basketball, 7 months ago he woke up with back pain. Since then, the pain has...
Pseudofusion Dilemma
By: Jason M. Highsmith, MD
A 53-year-old, nonsmoking woman came to the clinic with increasing back and right leg pain despite undergoing an L4-S1 Transforaminal Lumbar Interbody Fusion (TLIF) and lateral mass fusion with...
Spinal Stenosis – Unresponsive to Nonoperative Treatment
By: Jason M. Highsmith, MD
A 65-year old male with multiple medical problems reports a long history of low back and leg pain with difficulty walking upright, especially during the last several months.
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