Downloaded from https://pdfs.journals.lww.com/jaapa by BhDMf5ePHKZxZb3ruX4b9cKfbT5h3bp+v9gTtSlrchDWvVTxyN8Hif2P/rPZfAxb8td684/2m6Qj/1S0ZObgiiKJ9vD64yNdY1wI1G/v4gN3ti1fujtTJsg5898WZFuC on 02/23/2019 A DIFFICULT DIAGNOSIS What is causing this patient’s bilateral leg weakness? Alicia Andaloro, PA-C CASE T9-T10 without cord compression, likely related to her A 57-year-old woman presented to the neurosurgery ofﬁ ce previous motor vehicle accident. A lumbosacral spine MRI with low back pain and bilateral leg weakness, which has showed a L5-S1 fusion with pedicle screws and proper progressed over the past 6 to 7 months. alignment, no adjacent level disease, and degenerative History Eighteen years ago, the patient was involved in changes at L5-S1. No evidence of an increased signal was a motor vehicle accident that caused neck and low back found in any of the three radiology tests. pain. Three years after the accident, she underwent an Based on the patient’s presentation and diagnostic test anterior cervical discectomy and fusion of C4 through C7 results, a neurologic consultation was suggested. A brain due to herniated disks. Her neck pain subsequently MRI with and without contrast and a bilateral upper and improved. Three years ago, she began falling intermittently lower extremity electromyogram (EMG) were ordered. and had increased low back pain. Two years ago, she had decompression and fusion of
Journal of the American Academy of PAs – Wolters Kluwer Health
Published: Apr 1, 2018
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