Clinical Presentation & Protocol
Patient Usually Complains Of
Patient is a postmenopausal female presenting with acute onset of localized lumbar back pain following minimal trauma (e.g., bending, lifting, or sudden movement). Pain is described as sharp, non-radiating, and exacerbated by weight-bearing or spinal flexion. No history of high-energy trauma. Denies neurological deficits, saddle anesthesia, or bowel/bladder dysfunction.
Clinical Examination Findings
Physical exam reveals focal tenderness over the affected lumbar spinous process. Range of motion is significantly restricted due to pain. Neurological examination of lower extremities is intact: motor strength 5/5, sensation preserved to light touch, and deep tendon reflexes are symmetric. No midline spinal deformity or step-off noted. Gait is antalgic.
Treatment Protocol
Management plan includes: 1. Orthopedic consultation for fracture stabilization (TLSO brace). 2. Analgesia with non-narcotic agents (NSAIDs or acetaminophen). 3. Initiation of bone-strengthening therapy (e.g., bisphosphonates or teriparatide) pending DEXA scan results. 4. Calcium and Vitamin D supplementation. 5. Activity modification with avoidance of heavy lifting. 6. Follow-up imaging to monitor fracture healing.