63y/m C/o Hib and lower extermity pain and burning and numbness sensation since 6 month. No h/o dm htn No past medical history Vital normal Rx Dx

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Osteoarthritis- lumber spine.

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Osteoporosis

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Degenerative changes in vertebrae Sacralisation of L5 Lumber spondylitis with osteophytes L4 is distorted Ad MRI lumber & sacral spines Ad Decompressive Surgery Discotomy Laminectomy

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Lumbar Spondylosis with lumbar scoliosis positional release of tight muscles, strengthening of back extensors and core muscles with orthotic support will help the individual

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To Do MRI spine for further evaluation Multiple disc degenerative disease To avoid weight lifting Neurosurgeon opinion

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Sacralisation of Limbo Sacral region caused intensified spondylitis...And nerve end opening and damages. Immediate surgical intervention in view of neuropathy involved.

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Rhus tox gnaphalinum

Multiple level degenerative disc disease Lumbar scoliosis Symptoms suggest radiculopathy and possible neurogenic claudication MRI evaluation Gabapentin will help Lumbosacral corset

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Disc space reduced... spinal canal diameter is reduced.. mri needed for exact nerve root compression level ... but must need spinal decompression as per xray....

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Severe lumbar spondylitis with osteophytes L5S1 distortion likely disc prolapse indentating thecal sac hence pt has h/o peripheral neuropathy Sacralisation of L5S1 Adv MRI LS region Rx surgical intervention decompression Conservative Tab gabapentin 300mg+nortryptiline 10mg 1od Tab etodac 600mg 1od Tab neurobion forte 1od Physiotherapy

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