Concluded Case

Multiple Lumbar disc with spinal canal stenosis

Back pain with pain , parasthesia and weakness of both lower limbs while walking and standing at kitchen in a 58 yrold female weighing 80 kg. Chief Complaints Presented with back pain sincec2- 3 yrs ,tried Ayurveda treatment . Pain is insidious in onset ,initially the pain was while getting up in the bed only.for the last one yr she has been getting pain and numbness in both legs while standing in the kitchen.For the last 6onths ,she is sitting in the chair and doing most of the kitchen works.Initislly about a yr ago she used to walk a kilometers. At the Beginning of Corona pandemic,she was walking with pain, numbness of the legs. While walking 30 mts, she used to get numbness and weakness of both lowrr limbs. After taking 5 mts rest,again she could continue to walk. Then for the last few months she stopped going out.For the last few months while walking at home also she gas pain and parasthesia in the legs.No bowel or bladder symptoms. History Hypertensive on Telmesartan. Family history of hypertension hrr maternal side. Non smoker Vitals Afebrile.BPc150/ 84mmhg. Hr 80/ mt. Physical Examination Neurological exam limited to back and lower limbs. She came by where chair.No bony tenderness in the back Intact lower limb pulsations.Motor system gr5/5 power DTrs absent bilaterally,knee jerks elicitable.Dulling of sensation L3 4 5 bilaterally Rt > left. Investigations Routein nloid work up including biochemistry ,Uric acid - normal. MRI Lumbosacral spine done.( report for discusdion). Diagnosis Clinical diagnosis- Neurogenic claudication Further diagnosis for discusdion Management Started on Pregabalin. Ref to spinal surgeon .Elective surgery fixed.Surgery after April only ,since she has her Son's marriage on April.

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Thanks Curofy and all doctors who answered. MRI Lumnosacral spine. *Diffuse pidyetior disc bulge L3-4,L4-5 indenting the thecal sac and causing mild bilateral neural foramina compression. * Ligamentum flava hypertrophy present causing effacement of lateral recess,AP diameter if bony cervical canal in mud sagittsl plane 10mm. *Central and left pist central disc bulge atL2- 3 indenting the thecsl space and causing mild left neural foramina compression.

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Thanks Curofy and all doctors who answered. MRI Lumnosacral spine. *Diffuse pidyetior disc bulge L3-4,L4-5 indenting the thecal sac and causing mild bilateral neural foramina compression. * Ligamentum flava hypertrophy present causing effacement of lateral recess,AP diameter if bony cervical canal in mud sagittsl plane 10mm. *Central and left pist central disc bulge atL2- 3 indenting the thecsl space and causing mild left neural foramina compression.

Multiple level degenerative disc disease with canal stenosis Will benefit from surgery at selected levels

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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!

classical lumbar canal stenosis history very well elicited and described by madam..the hall mark is lot of symptoms but no signs... the one and only curative treatment is surgery. these patients need lumbar canal decompression and earlier the surgery, better is the result...unfortunately most these patients like this case, are lured into unscientific non operative managements and they suffer. late surgeries give less than satisfactory outcomes as permanent nerve and appendage damage has already occurred...collectively, medical fraternity should educate themselves to encourage and guide these patients to neurosurgical treatments rather than falling into traps of quakes, and lures of unscientific incurative non operative treatments

Desicated discs at L3L4 L4L5 and L5S1 with narrowing of spinal canal at L5S1 Cauda equina syndrome Rx decompression with laminactomy

IV disc dedication L3TO 5 SPINAL CANAL NARROING S1 NEUROSURGEON IS ONLY HOPE

Neurogenic claudication.

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