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Genomic Spine Disease
Case Presentations
 

  Disc Herniation Producing Cauda Equina Compression
in a 15 year old girl   

 
        
 

Shown above are some remarkable MRI scans of a 15 year old female high school student showing classic evidence of JDD and associated degenerative changes.  A large disc herniation at L4-5 level has produced marked compression of the nerve roots of the cauda equina, as shown on the right.  This student's mother also had JDD and unsuccessful spine surgery earlier in her life.  At the time of decompressive surgery on this patient segmental instability was documented at the L4-5 level and restorative spine surgery using a single posterior titanium cage and dorso-lateral strut stabilization was carried out.
 
  Disc Herniation Producing Complete Foot Drop and Bladder Impairment   
 
   
 
 
R. M. is a 48 year old police chief with back pain over 20 years due to a genomic spine condition.  He underwent discectomy in 1977 and in February 2002 developed complete foot drop on the right associated with bladder problems.  At the time of this discectomy a dorso-lateral strut was placed from L3 to the sacrum to address multi-level segmental instability.  A 3-D reconstruction CT image performed 1½ years following surgery is shown.  Patient experienced complete recovery of motor and sensory function and for the first time in many decades was free of back and leg pain (see questionnaire).  This is an example where restorative surgical techniques were employed to provide long-lasting, more physiologic, and effective results for a genomic condition.
 
 
D.K. is a 50 year old whose multi-level genomic disease process was finally documented in 2003.  Like many patients with genomic problems D.K. experienced herniated lumbar discs for which he had surgery in 1984 and 1986.  Because of continuing back pain he was seen by a scoliosis/deformity spine specialist who performed a rigid 3 level pedicle screw instrumented posterior and an interbody fusion in 1996.  Patient's pain and disability were not improved and he was referred to a Pain Management Clinic where a morphine pump was implanted in year 2000.  Because the intrathecal catheter caused thoracic adhesive arachnoiditis producing catheter obstruction the morphine pump and catheter had to be removed.  D.K. remains incapacitated and continues to take strong narcotic medications to help him make it through the day.

The case presented above is true.  Unfortunately, this story is not a unique one.  The on-going failure to properly diagnose and appropriately treat multi-level degenerative problems associated with genomic conditions, are responsible for many similar treatment disasters.