No Neurological Findings What Other Images Do You Want? STIR Images STIR images suppress fat in the marrow so fluid (water) shows up Look at L5 now- lights up=compression fracture With minimal force in fall and fracture, need bone densitometry to look [...]
No neurological findings Bowel and bladder intact (how do you check?) Current kyphosis is about 10 degrees 50% canal compromise What treatment do you recommend? Custom Extension Type TLSO Brace •19 degree kyphosis •(Surgery considered for 25-30 degree kyphosis) •50% or less canal compromise •No neurological [...]
DISH (Diffuse Idiopathic Skeletal Hyperostosis) •Forrestier’s Disease •“Flowing Bone” ossification of the spinal ligaments •Creates synostosis of vertebra and reduction of ROM •Can be found with DDD but commonly found in normal height discs too •Associated with Diabetes
What is it at L3? Pars Stress Fracture? Note STIR and T1 images Atypical Hemangioma Fat is bright on T1 images but water is black On STIR images, fat is suppressed but [...]
Grd II Deg spondylolisthesis with IDR Or This One? Grd I DS with rotation and angular collapse The Second One Has Symptoms, The First One Does Not •Use images to consider what [...]
HX of LBA, LBP only with flexion and impact Had microdiscectomy L5-S1, 4 years earlier No leg pain now-what would MRI show? Note disc height narrowing, history of microdisc and no leg pain Modic [...]
78 yo Patient who can’t walk more than 70 feet without upper LB ache that stops her •Note flexed forward posture •Bent knee stance •Hypo-lordotic lumbar spine •Pain gone with sitting and lying down •What 6 things cause this deformity? Flat Back Posturing [...]
Caused by a lifting episode, developed initial RLBP 2 days later, radiated down leg 80% R SI P, 20% RLE P Pain aggravated by sitting, better with standing Can’t tie R shoelace Where does pain radiate to? Right SI and Lower Extremity Pain X-Rays demonstrate [...]
•Standing, walking pain •Came on insidiously •80% RLE P •Worse towards EOD •Relieved by sitting •No pain with sleeping What do you see? Look Carefully at L4-5 •Slight slip (DS) at L4-5 [...]
Pain location, higher than last visit (90% LBP) Pain more intense and patient has impact and vibration aggravations Can’t do typical recreational activities Pain 3 years ago controlled with core strength and epidurals IDR L3-4 Pain is located higher in back than previous involvement 3 years [...]
