Showing Case Studies for: Herniated

Trans-sacral Approach to Chronic Low Back Pain

Presented by: D. Hart MD

After prior lumbar microdiscectomy procedures (years ago), both at L5-L6, the patient presents with chronic low back pain.

Novel Treatment of Neck and Arm Pain

Presented by: C. Kim MD, PhD

The patient, a 59-year-old female, presents with neck and arm pain that was not effectively relieved by interlaminar epidural steroid injections and physical therapy.

Sciatica Sidelines a College Athlete

Presented by: T. Zdeblick MD
The patient is a 21-year-old female college varsity athlete who presents with a 4 month history of sciatica.

Left C5-C6 Foraminal Disc Herniation

Presented by: R. Fessler MD, PhD
The patient is a male over 60 years of age, who reports that he had an episode of extremely severe right arm and hand pain beginning approximately 3 months ago. That pain was initially treated with a collar and pain medication but, with no relief. Epidural injections were then attempted and did provide temporary pain relief.

Progressive Low Back Pain in an At-risk Patient

Implantable Stimulation for Increasing the Probability of Fusion Success
Presented by: R. Davis MD, FACS
A 71-year-old widowed housewife presents with a long history of progressive low back pain. At presentation, her VAS is 8. Onset was insidious without a clear precipitating event. She describes her pain as deep and aching with occasional sharp exacerbation, involving the low back, bilateral buttocks and anterior thighs to the knees.

Lumbar Radicular Symptoms in a 24-year-old Male

Presented by: M. 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.

Superior Articular Facet Interbody Reconstruction (SAFIR)

A novel posterior lumbar interbody fusion approach
Presented by: J. Ammerman MD, J. Wind MD
A 74-year-old presents with 9 months of back and R > L leg pain. Four years ago, she underwent L4-S1 ALIF with pedicle screws. Her ODI is 20.

Severe Thoracic Pain

Presented by: T. Piper MD, C. Hemmer DNP, ANP
A pleasant 37-year-old female presents with severe midline thoracolumbar pain at and just below her bra line. The pain started about 12 months ago but has significantly worsened during the past 3 months making wearing a bra painful. She has no history of shingles or trauma.

Sudden Right Foot Drop after Skiing

Presented by: C. Kim MD, PhD
An avid skier and mountain biker presents with a sudden right foot drop after skiing. She has a transient left leg radiculopathy that improved with a bilateral L4-L5, L5-S1 transforaminal epidural steroid injection. However, persistent weakness in right ankle dorsiflexion has prevented her from returning to her activities.

Large Partially Calcified Thoracic Disc Herniation

Presented by: M. Perez-Cruet MD
A 48-year-old female with obesity presents with severe right leg pain and paraparesis. Imaging of the thoracic spine reveals a large partly calcified right-sided T10-T11disc herniation with marked spinal cord compression.

Foreign Diplomat with Neck Pain and Right C6 and C7 Radiculopathies

Presented by: R. Fessler MD, PhD
A 59-year-old male who is a foreign diplomat presents with neck pain and right C6 and C7 radiculopathies.

Neck Pain with Radiation into Right Radial Arm

Presented by: R. Fessler MD, PhD
How would you treat this? The patient is a 43-year-old female with neck pain with radiation into the right radial arm, thumb and first finger, and ulnar forearm into small and ring finger. Richard G. Fessler, MD, PhD, presents this spine surgery case.

Cervical Myelopathy: Progressive Problems with Balance and Handwriting

Presented by: J. Wang MD
A 54-year old male with a prior history of a herniated disc at C5-C6 had an ACDF 8 years ago for arm pain and radiculopathy. In the past 8 months, he has had problems with balance and handwriting and clumsiness with his hands. He was found to have adjacent segment disease and cervical stenosis leading to cervical myelopathy.

Cervical Disc Herniation Adjacent to Fusion

Presented by: T. Albert MD
The patient is a 26-year-old healthy, nonsmoker, non-laborer. A year ago, he underwent C5-C6 anterior cervical discectomy and fusion and now presents with new and acute symptoms.

Acute Onset of Back and Left Leg Pain

Presented by: J. Ammerman MD, J. Wind MD
The patient is a 52-year-old male with the acute onset of back and left anterior thigh pain for 2 weeks. Pain is unresponsive to oral steroids and nonsteroidal anti-inflammatory drugs.
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