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March 10, 1999

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

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(10):893-895. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-10-jac90000

To the Editor: In the article by Dr Weinstein,1 the options offered to the patient by the orthopedic surgeon and the neurosurgeon were not realistic. I think the option that should have been offered to the patient was either laminectomy and excision of the herniated disk or nothing. I do not understand why the patient was offered a spinal fusion, as that is certainly not indicated in this particular case. A laminectomy, however, is. I think that if this patient has a foot drop, as would seem to be indicated from his limping while he runs, many of us in the orthopedic field would feel that he should undergo a laminectomy.