“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus

INTRODUCTION: Herniated Nucleus Pulposus is displacement of disc material beyond the intervertebral disc normal margins resulting in pain, weakness or numbness following the myptomal or dermatomal distribution. We present a patient with severe L4/L5 herniated nucleus pulposis who presented with “po...

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Main Authors:	Ren, Yi Kow, Mor Japar Khan, Ed Simor Khan, Komahen, Colin, Low, L. C.
Format:	Conference or Workshop Item
Language:	English
Published:	Malaysian Orthopaedic Association 2018
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/1/63876_Postural%20Kyphoscoliosis.jpg.pdf

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spelling	iium-638762018-06-26T08:53:54Z http://irep.iium.edu.my/63876/ “Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus Ren, Yi Kow Mor Japar Khan, Ed Simor Khan Komahen, Colin Low, L. C. RD701 Orthopedics INTRODUCTION: Herniated Nucleus Pulposus is displacement of disc material beyond the intervertebral disc normal margins resulting in pain, weakness or numbness following the myptomal or dermatomal distribution. We present a patient with severe L4/L5 herniated nucleus pulposis who presented with “postural kyphoscoliosis” CASE REPORT: Mr YMC, a 22-year-old healthy gentleman presented with abnormal posture and back pain for 3 months. There was no history of trauma. Clinically the “kyphoscoliosis” was postural due to severe back pain on straightening the back. On examination, straight leg raising test was positive with L4 mytomal symptoms. Plain radiograph of the thoracolumbar region did not reveal any deformity. The magnetic resonance imaging of lumbosacral revealed a herniated lumbar nucleus pulposus over the L4/L5 region, impinging on the L4 exiting nerve root. The patient underwent laminectomy L4 and discectomy L4/5 without any complication. Post-operatively, the patient recovered well with normal posture. DISCUSSIONS: It is still controversial in terms of outcomes of medical and or physical therapy compared to surgical intervention in herniated nucleus pulposus. In those patient that warrant surgical intervention, patient with age<40 and sugery within 6 months would predict a good surgical outcomes. In our patient, the surgery improves the motor function, correct the posture and improve his quality of life. CONCLUSION: This case highlights the surgical role in terms of managing patients with prolapsed nucleus pulposus that failed conservative management. Early surgical intervention yields a good functional outcome in those patient with severe disease. Malaysian Orthopaedic Association 2018-05-10 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/63876/1/63876_Postural%20Kyphoscoliosis.jpg.pdf Ren, Yi Kow and Mor Japar Khan, Ed Simor Khan and Komahen, Colin and Low, L. C. (2018) “Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus. In: 48th Malaysian Orthopaedic Association Annual Scientific Meeting / Annual General Meeting 2018, 10th-12th May 2018, Hotel Equatorial, Penang. (Unpublished) http://morthoj.org/supplements/2018/ES01-Herniated-Lumbar-Nucleus.pdf ES 01
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Ren, Yi Kow Mor Japar Khan, Ed Simor Khan Komahen, Colin Low, L. C. “Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
description	INTRODUCTION: Herniated Nucleus Pulposus is displacement of disc material beyond the intervertebral disc normal margins resulting in pain, weakness or numbness following the myptomal or dermatomal distribution. We present a patient with severe L4/L5 herniated nucleus pulposis who presented with “postural kyphoscoliosis” CASE REPORT: Mr YMC, a 22-year-old healthy gentleman presented with abnormal posture and back pain for 3 months. There was no history of trauma. Clinically the “kyphoscoliosis” was postural due to severe back pain on straightening the back. On examination, straight leg raising test was positive with L4 mytomal symptoms. Plain radiograph of the thoracolumbar region did not reveal any deformity. The magnetic resonance imaging of lumbosacral revealed a herniated lumbar nucleus pulposus over the L4/L5 region, impinging on the L4 exiting nerve root. The patient underwent laminectomy L4 and discectomy L4/5 without any complication. Post-operatively, the patient recovered well with normal posture. DISCUSSIONS: It is still controversial in terms of outcomes of medical and or physical therapy compared to surgical intervention in herniated nucleus pulposus. In those patient that warrant surgical intervention, patient with age<40 and sugery within 6 months would predict a good surgical outcomes. In our patient, the surgery improves the motor function, correct the posture and improve his quality of life. CONCLUSION: This case highlights the surgical role in terms of managing patients with prolapsed nucleus pulposus that failed conservative management. Early surgical intervention yields a good functional outcome in those patient with severe disease.
format	Conference or Workshop Item
author	Ren, Yi Kow Mor Japar Khan, Ed Simor Khan Komahen, Colin Low, L. C.
author_facet	Ren, Yi Kow Mor Japar Khan, Ed Simor Khan Komahen, Colin Low, L. C.
author_sort	Ren, Yi Kow
title	“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
title_short	“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
title_full	“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
title_fullStr	“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
title_full_unstemmed	“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
title_sort	“postural kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus
publisher	Malaysian Orthopaedic Association
publishDate	2018
url	http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/ http://irep.iium.edu.my/63876/1/63876_Postural%20Kyphoscoliosis.jpg.pdf
first_indexed	2023-09-18T21:30:36Z
last_indexed	2023-09-18T21:30:36Z
_version_	1777412484506845184

“Postural Kyphoscoliosis”: an atypical presentation of herniated lumbar nucleus pulposus

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