40+ female history of fall 7 moths back, now pain and weakness in both lower limbs. undergone physiotherapy 7 months back. symptoms has reappeared. hyperglycemic. comment on x ray specially bony fragment on lateral view

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MRi Spine, also Flexion Extension Views to know Segmental Instability, specially as symptoms appearing after 7 months. Depression Stabilisation fusion based on findings. Also need to know any recent urgency of bladder. Clinical findings of detailed neurological examination need to be submitted for better analysis.

advise MRI , in Case of progressive neurological deficit. advised post. instrumentation , with international screws and rods . followed by aggressive rehab program

symptoms of both legs could not be due to anterior wedge compression..it is due to l5-s1 canal stenosis...so do mri n identify d severity f d condition..

what about management
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I presume the weakness must be due to l5s1 ivdp. Kindly get an MRI and proceed.

MRI stop movment and strain go for further as advised by dr simarjit

Compression. With wedge fracture. ? Metastasis

I too suspect wedge # but patient undergone physiotherapy and felt relieve of pain. now again symptoms reappeared. is there a need to correct # patient has lost lumbar lordosis, it's a flat back
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interpedicular

It seems to b a chip..only anterior column is fractured..thrs loss of lumbar lordosis. .but disc spaces r maintained.wht do u mean by weakness.?neurological deficit. .grly shudnt b thr..but as pt is not improvin..consider mri..hope thrs no other injury or infection externally as confounding factor

l4 compression fracture with loss of lordosis..she must be osteoporotic.get mri.detailed exam n then review for medical vs surgical mx

I don't think the bony fragment is responsible for weakness in lower limbs. It could be L5-S1 disc. I will advise MRI.

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