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March 10, 1999

Clinical Crossroads: A 45-Year-Old Man With Low Back Pain

Author Affiliations

Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

JAMA. 1999;281(10):893-895. doi:10.1001/jama.281.10.893

To the Editor: The Clinical Crossroads1 about the 45-year-old attorney with low back pain was intriguing and brought out some of the diagnostic dilemmas in the practice of clinical medicine.

The patient consulted an orthopedic surgeon who recommended lumbar laminectomy with spinal fusion. The patient then obtained consultation with a neurosurgeon who advised against surgery and recommended that the patient should give up jogging. The discussant, Dr Weinstein, suggested that the patient should continue running and doubts that the patient will suffer any harm. Thus, the patient consulted 3 competent experts and received 3 different opinions regarding the management of his low back pain and numbness of his left foot.