Medical Fitness Evaluation
Introduction One major issue when considering reconstructive spinal surgery is medical fitness for surgery. This is defined as an individual’s ability to sustain the physiological stress of surgery and recovery….
The Role of Osteoporosis and Bone Diseases in Revision Spine Surgery
Introduction Poor bone health can lead to failure of the primary spinal procedure and precipitate the need for a revision spine surgery. Postoperative complications related to poor bone health include…
A Young Man With Large and Stiff Muscles
An 18-year-old patient had complained of muscle stiffness since he was 2½ years old, impairing his ability to exercise. He felt less stiff after warming up, and cold made the…
A Woman With Proximal Muscle Weakness and Neuromuscular Irritability
A 67-year-old woman presented with a 6-year history of mild difficulty climbing stairs, rising from a chair, and lifting her grandchild. She denied difficulty swallowing, numbness, shortness of breath, fasciculations,…
A Woman With Focal Spontaneous Muscle Movements
A 42-year-old right-handed, Black woman came complaining that her leg muscles got tight and “moved on their own” for about 4–5 months prior to presentation and had gotten progressively worse….
A Woman With Muscle Cramps and Fasciculations
A 53-year-old woman complained of frequent muscle spasms, cramps, and mild fluctuating weakness in the arms and legs for 6 years. She initially had difficulty rising from a squat position…
A Boy With Short Stature, Small Jaw, Muscle Hypertrophy, and Stiffness
A 5-year-old boy was seen for muscle stiffness. He was the product of a normal pregnancy of a 27-year-old woman and had normal developmental milestones until he developed progressive limb…
An Elderly Woman With Muscle Spasms
An 81-year-old woman with a history of thyroidectomy for thyroid carcinoma presented 2 years later with recurrent muscle spasms, muscle pain, and weakness. Her serum calcium levels were consistently in…
A Woman With Generalized Increased Insertional Activity on EMG
A 41-year-old woman with no past medical history was referred for an EMG because of right shoulder pain. She denies neck pain. There was no family history. She denies stiffness….
A Man With Muscle Stiffness and Later With Diplopia
A 31-year-old, right-handed man presented with left hip and low back spasms which eventually spread to all four limbs and the entire back bilaterally. Neurologic examination showed normal mental status…
