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Dear friends,
                    It seems only fair to let you know ,the follow up of the case I presented
to the list few days back,
in brief a 45yrs shopkeeper developed  paresthesia of ulnar area
of both upperlimbs along with medial side of both thigh,there was no history of pain.trauma
fever ,Range of motion of cervical and lumbar spine was normal,only sense of constriction in the umbilical area. MRI investigation revealed a massive prolapsed of C5C6 .Mostly opinion of the list was to consider clinical symptoms above MRI and treat conservatively  as  many patients are having having asymptomatic  disc Few strongly recommended surgery,as the case had few syptoms and no pain he was recommended physio i.e
traction ,he started to improve with daily traction,all was well till last
Thursday when he woke up he was unable toget up from bed and hence rushed to surgeryand operated same day.
Morale of story is :  clinical picture can be very  deceptive in  disc prolapse one must always be on quard as far prognosis is concerned  and never to be overconfident,as sometimes back pain
cases with advanced pain respond in few minutes centrtalize and doctor and patients both are happy sometimes even simple looking case becomes resistant to all the treatment.In end let
us all continue the search for  BEST solution of BACK-PAIN which is most clever and cunning
in presentation.
Dr.Sarveshwar Sood
Orthopaedic Surgeon & Head Department of Physical
Medicine & Rehabilitation,
Member American Academy Of Pain Management.
S.B.L.S.Hospital
812/1,Housing Board Colony
Model Town,Jalandhar city
Punjab State.India
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