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spinemonitor: Neck & Back Pain eNewsletter from September 10, 2008

This edition of spinemonitor features two original cases.  First, Christopher I. Shaffrey, MD presents adult scoliosis with progressive lower extremity radicular pain.  Steven R. Garfin, MD discusses Dr. Shaffrey’s case, including his suggested treatment.  Next, Kevin T. Foley, MD presents treatment of lumbar herniation.  Richard D. Guyer, MD provides case commentary.

Featured Case Study - I
Adult Scoliosis: Progressive Lower Extremity Radicular Pain
Christopher I. Shaffrey, MD Case Author:
Christopher I. Shaffrey, MD
Professor, Department of Neurological Surgery
University of Virgina
Charlottesville, VA

The patient is a 44-year-old female who underwent scoliosis surgery (T3-L4) at age 14. She presents with low back pain for
6-years and progressive lower extremity radicular pain...

Her neurological exam revealed 4/5 weakness for left extensor hallicus longus and decreased sensation at L5, left greater than right.

The patient was diagnosed with...

Read Complete Case, Vote for Treatment, and View Outcome

Adult Scoliosis: Progressive Lower Extremity Radicular Pain

Fig. 2 - Lateral x-ray shows 4.2 cm PSB
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How Would You Treat this Patient?
Sponsored Technology Case Study
Lumbar Herniated Disc Unresponsive to
Prior Treatment
Kevin T. Foley, MD Case Author:
Kevin T. Foley, MD
Professor of Neurosurgery
University of Tennessee
Memphis, TN
This case sponsored by: ArthroCare

The patient is a 42-year-old female with a 5-month history of buttock and right leg pain with a spontaneous onset. She also complains of a small element of back pain, but rated it 10% compared to 90% leg pain. Pain is worsening, incapacitating and has caused...

Positive straight leg raise at about 70-degrees with full motor strength bilaterally. There are no sensory deficits and reflexes are normal bilaterally. The patient complains of a paresthetic-type pain that runs...

Prior Treatment
She had 2 blocks. The first, 4-months ago, helped somewhat. However, the second, 2-months prior...

Read Complete Case, Vote for Treatment, and View Outcome

Fig. 1 - Herniated nucleus pulposus at L4-L5
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How Would You Treat this Patient?
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Spine Surgery Videos
OR-Live Spine Surgery Videos

We have partnered with OR-Live to bring you videos covering breakthrough procedures. Chronic pain therapy, nucleoplasty, vertebroplasty, PLIF, TLIF, minimally invasive techniques, and others.
View all videos
Past Spine Cases:
Below is a listing of previous spine case studies. Feel free to browse and vote for treatment options for each case.
Cervical DDD with Myelopathy?
By Richard G. Fessler, MD, PhD

Increasing Back and Leg Pain, Quadricep Weakness
By Timothy R. Kuklo, MD, JD

Cervical Trauma Resulting in Quadriplegia
By Christopher I. Shaffrey, MD

Intractable Chronic Pain in Patient with Post-laminectomy Syndrome
By Leonardo Kapural, MD, PhD

Gait and Balance Difficulties in a 76-Year-old Male
By Richard G. Fessler, MD, PhD

Lumbar Herniation with Radiculopathy
By Timothy R. Kuklo, MD, JD

Cervical Trauma in a Young Football Player
By Christopher I. Shaffrey, MD

Bilateral L2 Spondylolysis: Nonsurgical or Surgical Treatment?
By Michael P. Schaefer, MD

Cervical Degenerative Changes with Segmental Kyphosis
By Marc A. Weinstein, MD

High-speed Motor Vehicle Accident: 24 Year-old
By Alexander Vaccaro, MD, PhD and D. Greg Anderson, MD

View All Case Studies

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