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Review Question - QID 7145

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QID 7145 (Type "7145" in App Search)
A 35-year-old man with a history of spine surgery 5 years ago reports the recent development of frequent low back pain radiating to the legs. The patient blames a low-energy fall that occurred 9 months ago for the recent symptoms. Radiographs reveal previous interbody fusions of L4-L5 and L5-S1, with hardware present. The vertebrae appear well-fused and stable. What is the most likely cause of the low back pain?

Increased range of motion and strains at L3-L4

72%

503/703

A herniated disk due to the fall

14%

98/703

A compression fracture

2%

17/703

Development of pseudarthrosis due to failure of the previous fusions

7%

52/703

Loosening of the hardware that was used for the previous fusions

4%

25/703

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It is increasingly recognized in the spine literature that fusion of two or more vertebrae produces increased range of motion in adjacent motion segments, resulting in increased stresses and, with time, degeneration of the adjacent disks. Loss of disk height would be an initial indication of disk degeneration. If the patient's fall had caused a fracture, the symptoms would have been immediate.

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