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Clinical Crossroads Update
April 28, 1999

A 45-Year-Old Man With Low Back Pain and a Numb Left Foot, 1 Year Later

Author Affiliations

From the Division of General Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 1999;281(16):1540. doi:10.1001/jama.281.16.1540

In March 1998, James N. Weinstein, DO, MS, discussed a 45-year-old attorney with some low back pain and a numb left calf and foot.1 The patient was an active and avid runner. Magnetic resonance imaging of the spine suggested possible herniation of 2 lumbar disks with questionable nerve root compression. An orthopedic surgeon recommended lumbar laminectomy with fusion. A neurosurgeon recommended against surgery but advised the patient to stop running. Dr Weinstein reviewed the medical and surgical treatment of low back pain with and without evidence of symptoms and signs of nerve root compression. He recommended that the patient not have surgery and continue running as he had been.

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