c/o Ch backache with weakness both arms and both legs difficulty in walking and standing suggest diagnose and treatment



The scan shows iv disc lesions more than one place.there are buldge or prolapse of discs at L3L4 andL4L5 latterone is huge prolase and old one as dryness of discs and sclerosis is seen . The prolapse is indenting the chord ie causing neurological deficit for lower limbs. So far upper limbs are concerned cervical mri is needed and what are bp and diabebtic status. So far treatment is concerned i think he needs to be hospitalised and decompression of chord by a neurosurgeon.

Thanks sir

View 2 other replies

The history of patient given is S/O of quadriparesis for which the patient requires MRI of the cervical spine. The given images of LS spine shows antero listhesis of L3/4. The cord ends at L1 and hence this will not cause any cord compression at this level (as suggested by many responders), and will cause only compression of cauda nerve roots. Listhesis is a long standing condition and causes significant claudication pain and other problems before leading to weakness of limbs and does not cause generally symmetrical weakness of Lowe limbs as suggested by history in this case. So before ascribing the weakness of lower limbs to the condition seen in MRI and operating, evaluation of cervical spine with MRI needs to be done .

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

L3-4 anterolisthesis with cord compression explains the lower leg weakness. As it is associated with upper limb weakness, MRI for cervical spine correlate clinically..

For arms mri of cervical spine as suggested many times. As there is significant disc protrusion and nerve compression, refer to a neurosurgeon as surgical decompression is required.

This is a case of quadriparesis.Needs MRI CERVICAL SPINE.

Decompression and spinal fusion Suggest: MRI Cervical spine

Traumatic anterolisthesis of L3 over L4 with pars interarticularis fracture. Cord compression is significant. It is the cause of weakness of bilateral lower limb. Cervical Spine MRI is required to clear the weakness of bilateral upper limb.

MRI cervical spine should be performed.

As you said there is weakness of both arms and legs kindly do MRI cervical spine to comment on quadriparesis.

Load more answers

Diseases Related to Discussion

Cases that would interest you