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spinemonitor: Neck & Back Pain eNewsletter from March 12, 2008
This special edition of spinemonitor features two completely different cases and the opportunity to select treatment on both cases!  Michael G. Kaiser, MD presents cervical degenerative disc disease in a relatively young man.  Discussion of Dr. Kaiser’s case is provided by Gerard J. Girasole, MD.  Burst fracture in an elderly man is the subject of Jason M. Highsmith, MD’s case.  Eeric Truumees, MD has provided an extensive discussion of Dr. Highsmith’s case, which is followed by the author’s response.
New Case Study 1
Cervical Degenerative Disc Disease:
34-Year-old Male
Photo: Timothy R. Kuklo, MD, JD Case Author:
Michael G. Kaiser, MD
Columbia University
New York, New York
The patient is a 34-year-old male with no significant past medical history.  His complaint is mild neck pain, which developed 2 months ago after falling caused him to strike his chin and hyperextend his neck...

Physical Examination:
The patient demonstrates normal range of motion.  There is no pain or paresthesias with flexion or extension.  He presents mild bilateral tricep weakness of 4+/5 and bilateral grasp weakness; left 4/5, right 4+/5...

The cervical x-ray shows cervical lordosis, mild spondylotic disease at C5-C6 and C6-C7 (Fig. 4)...

Cervical spondylotic myelopathy with associated left C7 radiculopathy....Read Complete Case, Vote for Treatment, and View Outcome

Cervical Degenerative Disc Disease - 34-year-old male

Fig. 4: Cervical x-ray shows no instability in extension view
Click here for Larger Images

How Would You Treat this Patient?
Sponsored by: KYPHON
Latest Spine Cases:
Below is a listing of previous spine case studies. Feel free to browse and vote for treatment options for each case.
16-Year-old with Grade 3 Spondylolisthesis
By: Timothy R. Kuklo, MD, JD

L1 Burst Fracture: Bracing or Surgery?
By: Lali Sekhon, MD, PhD, FRACS, FICS

Adolescent Disc Herniation: Conservative or Surgical Treatment?
By: Reginald Q. Knight, MD

Severe Low Back Pain in a 90-Year Old Male
By: Steven Richeimer, MD

Adjacent Segment Degeneration after Previous Decompression and Fusion
By: David W. Polly, Jr., MD

Degenerative Disc Disease
By: David W. Polly, Jr., MD

Cervical Pseudoarthrosis and Adjacent Level Disease
By: Jason M. Highsmith, MD

New Case Study 2
Burst Fracture in a 79-Year-old: How would you treat?
Photo: Jason M. Highsmith, MD Neurosurgeon Case Author:
Jason M. Highsmith, MD
Charleston, South Carolina
The patient is a 79-year-old man with a history of hypertension.  From ground level, he fell off a curb.  He presented one week after the fall with worsening mid back and left flank pain...

Physical Examination:
His exam revealed tenderness at the thoracolumbar junction, but no neurological deficits...

Prior Treatment:
Despite NSAIDs and narcotic pain medications, his pain worsened.


A CT scan showed a L1 compression fracture with a retropulsed fragment causing 40% canal compromise (Figures 1, 2).  Osteopenia and other chronic degenerative changes were noted...

The patient has a L1 burst fracture with osteopenia...
Read Complete Case, Vote for Treatment, and View Outcome

Burst Fracture in a 79-Year-old

Fig. 2: CT scan shows a L1 compression fracture with a retropulsed fragment causing 40% canal compromise
Click here for Larger Images

How Would You Treat this Patient?
Featured Event
The Scoliosis Research Society Presents:
15th International Meeting on Advanced Spine Techniques

July 8-11, 2008
The Hong Kong Convention and Exhibition Center
Hong Kong

Lawrence G. Lenke, MD

The IMAST meeting gathers leading spine surgeons, innovative research, and the most advanced spine technologies in an international forum.  Conference highlights include “East vs. West” debates, motion-sparing devices, nucleus replacements, biologics and other spine technology updates.  Advances in the treatment of scoliosis, trauma, tumors, and degenerative diseases, as well as “Spine Fundamentals” sessions with hands-on opportunities.

IMAST - Hong Kong

View Event Details
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