Showing Case Studies for: Iatrogenic

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

Presented by: S. 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?

PMMA Extravasation Following Kyphoplasty

Presented by: E. Truumees MD
The patient is a 72-year-old female who underwent kyphoplasty to treat a T12 burst fracture two weeks ago at a different hospital. After the kyphoplasty procedure, her back pain increased and a new symptom of lower extremity weakness, right greater than left developed.

Cervical Nonunion and Kyphosis

Presented by: C. Regan MD, J. Kang MD
A 40-year-old ICU nurse practitioner presented for a second opinion about 12 months after C4-C7 laminectomy and fusion with allograft. She reported posterior neck pain radiating down into the shoulders.

Fixed Cervical Kyphosis and Recurrent Myelopathy

Presented by: T. Albert MD
The patient is a 69-year-old male who had PCDF in 2009. He now presents with severe neck pain/weakness and loss of horizontal gaze. Vote in SpineUniverse's Interactive Case Library for how you would treat this patient.

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

No Evidence of Myelopathy
Presented by: T. 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.

Rapidly Progressing Cervical Adjacent Segment Disease

Presented by: J. Highsmith MD
A 56-year-old woman presents with a history of worsening neck and left shoulder pain. She has had some relief with C4-C5 epidurals, but her pain has persisted. She has had previous C6-C7 anterior cervical discectomy and fusion (ACDF) with plate in 2002. That was followed by explanation of instrumentation and subsequent C5-C6 ACDF in 2007.

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.

Severe Sagittal Imbalance Correction

Presented by: A. Daniels MD, D. Reid MD, M. Palumbo MD
A 76-year-old male presented with severe positive sagittal imbalance and neurogenic claudication following a prior L3-S1 decompression and fusion performed by a community neurosurgeon.

Lumbar Failed Back Surgery Post Laminectomy

Presented by: H. Deutsch MD
Failed back surgery syndrome in a 69-year-old male celebrity, who had multilevel lumbar laminectomies in 2015 by a surgeon other than the case author.

Adult Sagittal and Coronal Imbalance: How to Correct?

Presented by: O. Boachie-Adjei MD
The patient is a 50-year-old female with chief complaints of back pain and postural deformity. She’s diagnosed with post-surgical sagittal and coronal imbalance: how do you adequately correct the deformity?

Retired Truck Driver with Progressive Axial Low Back Pain

Presents with Radiculopathy, and Cauda Equina Syndrome
Presented by: M. Dekutoski MD
The patient is a 66-year-old male retired security truck driver. He underwent an L3-S1 in situ fusion for leg pain and spondylolisthesis 30 years prior to presenting in our office. He now has a primary complaint of pain that worsens with activity and at the end of the day.

L4-L5 Grade II Spondylolisthesis: Failed Laser Spine Surgery

Presented by: J. Uribe MD, FAANS
A 52-year-old female with a long-standing history of low back pain and radicular pain initially presented with a grade I spondylolisthesis. She received extensive medical treatment, but it failed to control her pain. She then had “laser” surgical decompression, but her pain persists and her spondylolisthesis has progressed to a grade II.

Iatrogenic Scoliosis in a Former Rock Guitarist

Presented by: N. Anand MD
A 68-year-old female ex-rock guitarist presented with a 5-year history of excruciating back pain that gets even worse with any activity. She says her pain is constant—24 hours a day

Post-laminectomy Instability

Presented by: G. Girasole MD
A 52-year-old female presented with incapacitating low back pain, a gross kyphotic deformity, and imbalance. She was unable to stand erect. She previously had an L3-L5 posterior spinal fusion and wide laminectomy at L2-L3.

Charcot Joint in a Paraplegic

Presented by: L. Sekhon MD, PhD, FAANS, FRACS, FACS
This 48-year-old man had been a complete T10 paraplegic, wheelchair bound since age 22. At the initial time of injury he had no surgery. Ten years prior to presentation in our clinic, the patient had undergone an L4-L5 and L5-S1 PLIF elsewhere, apparently for low back pain.
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