Trans-sacral Fusion of Spondylolisthesis at L5-S1

April 17, 2010 - PRLog -- Examination

The patient is a healthy 5'11" male who weighs 205 pounds. Vital signs are normal. His musculoskeletal examination was significant for left trunk tilt, antalgic gait, right leg limp, visible listhetic crease in his trunk near L5-S1, as well as pain on deep pressure in that region. There is no visible atrophy of arm or leg musculature.

His neurological examination revealed weakness of the right extensor hallucis 4/5 and right gastrocnemius 5-/5 with subjective pin numbness and decreased 2-point discrimination in the right L5 distribution. He has a positive straight leg raise and crossed-leg raise sign.
Prior Treatment

He completed a comprehensive 4-month physical therapy program involving Pilates, core strengthening, and weight loss of 15 pounds that provided moderate pain control.

He has had numerous transforaminal, translaminar, and facet cortisone injections at L5-S1 with only transient relief.

After an extensive discussion regarding management options, both nonsurgical and surgical, the patient decided to pursue surgery.






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