Hemangioma Case Studies

Assessments are lumbosacral intervertebral disc disorder with radiculopathy, lumbar spondylosis without myelopathy or radiculopathy and myalgia.

He underwent an interlaminar injection in May 2015 which improved his lower extremity pain by 99%. This has lasted him up until 1 month when he has had recrudescences of pain emanating from the low back radiating intermittently into the left lower extremity in a sharp shooting fashion, average pain 5/10, and worse pain 81/0. The pain is frequent and is associated with numbness and tingling. There is some difficulty with walking. Over the past 1 month, the pain has been severe. Home exercises and nonsteroidal anti-inflammatory medications (NSAIDS) have not been effective in reducing his pain and the pain is severe at times and limiting his ability to lift and sit. Walking, exercise and standing increased the pain. Lying down reduce the

Per AME report dated 05/11/15 by Dr. Pang, it was opined that the IW has reached MMI. Whole person impairment is 12 % for the thoracic spine and 17% to the lumbar spine. MD recommends provisions for the IW to seek medical attention for flare-ups or exacerbations with the possibility of undergoing PT, medications, further diagnostic imaging and

Treatment plan includes saliva toxicology, lumbar MRI with and without contrast and lumbar back brace to provide symptomatic relief for chronic low back pain and to reduce pain by restricting mobility of the trunk and to support the weak spinal muscles. Goal is to facilitate healing of the lumbar spine.

10/30/15 Medical Evaluation reported neck, low back, and left sacroiliac pain. Physical examination of the lumbar spine revealed decreased ROM on

DOI: 4/01/2015. The patient is a 53-year-old-male old carpenter /foreman who sustained a work- related injury while lifting a high beam when the beam slipped before being placed into the ground pushing him between the beam and leads, crushing his right ankle and foot.

The patient is a 36-year-old individual who sustained an injury on 01/30/17 due to lifting.

Based on the progress report dated 11/10/16, the patient states that he is feeling slightly better in the lower back area. Pain and discomfort in her lower back is rated as 9/10. She reports constant low

On the statement of medical necessity per MG-2 form dated 10/18/16, the patient wants to repeat left L5-S1 x 1 for longer lasting pain relief. History and physical examination was consistent with lumbar radiculopathy/radiculitis (radiating pain and concordant MRI findings). She has failed conservative treatment options including nonsteroidal anti-inflammatory drugs (NSAIDS),exercise, core strengthening and PT. Pain limits the patient’s function, as well as restricts Activities of Daily Living. It is reasonable to try a left L5-S1 ESI x 1 for pain relief. If there will be no benefit, an interlinear approach will be attempted.

MRI of the lumbar spine dated 11/02/16 showed status post right sided microdiscectomy at L5-S1. There is an enhancing scar tissue between the right L5 transverse process, right facet joint and sacrum with tiny 5 mm focus of fluid signal intensity likely seroma/minimal residual seroma. The iliolumbar ligament adjacent to the scar tissue appears to be intact.

She subsequently has increasing pain in her right hip and left knee, thus beginning increasingly worse over the past few weeks. It has been over a year since she last had physical therapy, and she reports previously doing water therapy has helped in the past with her focal dystonia. She takes hydrocodone up to twice a day, which does help her pain. Pain is rated as 10/10.

Assessments include recurrent exacerbation of low back pain with slight increased walking tolerance and pain-limited mobility, residuals of lumbar strain with underlying lumbar spondylosis, residuals of lumbar facet syndrome with radiculopathy, status post right ankle inversion sprain with talar dome lesion, status post right ankle arthroscopic surgery and peroneal tendon repair, neuropathic pain and

Based on the medical report dated 08/31/15, the patient complains of low back pain, associated with numbness and parethesias. She has been treated with PT and is scheduled for her first lumbar ESI. On examination of the lumbar spine, range of motion shows anterior flexion of 30 degrees and extension and bilateral lateral bending of 10 degrees, all with pain. Straight leg raisin test is positive bilaterally Assessments are displacement of cervical and lumbar intervertebral discs without myelopathy. Conservative treatment consisting of PT, anti-inflammatory medication, pilates and/or

01/06/16 Pain management Report described that the patient has a history of chronic low back pain and right lower extremity pain. The patient has a spinal cord stimulator since 01/30/15. The patient visited today for follow-up and medication refill. He reported that his pain has been stable since the last month. His pain is 5/10-scale level with the use of medications and 8/10-scale levels without the use of medication. The patient reported that the medications, activity restriction,

The latest progress report noted that the patient has neck and low back pain rated 7/10. The Physical exam revealed restricted ROM in the lumbar spine. TTP and