CONGENITAL SPINE DEFORMITY, CONGENITAL STENOSIS, DIASTEMATOMYELIA, AND TIGHT FILUM TERMINALE IN A WORKMENS-COMPENSATION PATIENT - A CASE-REPORT

Study Design. This case report concerns a patient injured at work who was denied adequate evaluation and treatment by a Workman's Compensati on Commission, resulting in nearly complete paraplegia. Objectives. Fo r a patient with a congenital spine deformity, a diastematomyelia, a t ight filum terminale, and a congenital stenosis, denial of magnetic re sonance imaging evaluation and appropriate surgery can not be justifie d. Summary of Background Date. This 35-year-old man injured his knee a nd back in a fall at work but was able to work for 1 week. Progressive neurologic deterioration was documented, but magnetic resonance imagi ng evaluation was denied. When it finally obtained and the lesion iden tified, appropriate neurosurgery was denied. Methods. When seen by the authors more than 3 years after his injury, he had a nearly complete paraplegia. Despite neurosurgical decompression and spine stabilizatio n, no significant recovery occurred. Results. A nearly complete parapl egia resulted from this combination of lesions coupled with intolerabl e delay in diagnosis and therapy, both the result of ''foot-dragging'' by a Workmen's Compensation Commission. Conclusions. In an effort to be ''cost-conscious'' and to avoid ''unnecessary low back surgery,'' a Workmen's Compensation Commission has caused a patient to become para plegic. Such management is neither cost-effective nor of adequate qual ity.