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The purpose of this study was to determine the effectiveness of a multi-modal physical rehabilitation protocol (MPRP) in reducing pain and disability and preventing surgery in patients with chronic lumbar radicular pain (LRP) at a minimum follow-up of 12 months. Pre and post-treatment NPRS score, ODI score, disability categories of 189 patients with chronic LRP treated with MPRP were analysed to determine the efficacy of the treatment. Patients were followed-up at a minimum duration of 12 months for pain, disability, surgery performed, and patient satisfaction with treatment. After a mean treatment of 59 days, there was significant reduction in mean NPRS (p < 0.0001) and mean ODI (p < 0.0001) scores. Of 89 patients (47%) who could be contacted at mean follow-up of 18 months, 9 patients (10%) had undergone lumbar surgery, 52 patients (58.5%) reported no pain or complaints related to their lower back and 66 patients (74%) were either very satisfied or satisfied with the outcome of their treatment. A MPRP is effective in significantly improving pain and disability in patients advised surgery for chronic LRP. At a minimum follow-up of 12 months, pain and disability continued to be significantly lower and only 10% (9/89) patients underwent lumbar surgery. [ABSTRACT FROM AUTHOR]

Nevus lipomatosus superficialis is a rare hamartomatous lesion of skin, also named as pedunculated lipofibroma. This entity is unknown to many primary care physicians, Hence, many times, it is not diagnosed and misinterpreted as any of its differential diagnoses like lipofibromas, skin tags, hemangioma, lymphangioma, and focal dermal hypoplasia. Histopathologically, it is characterized by the presence of clusters of mature fat cells in the dermis. Here we report a case of an 11-year-old male who presented with a lower back swelling since birth (4.8 x 3.6 cm) which gradually increased over time and became lobulated, pedunculated, and non-tender. It is an uncommon entity with distinct clinical and histopathological features. Awareness about this lesion, its clinical presentation, morphological features, and favourable outcome is necessary so that it can be differentiated from other skin neoplasms. [ABSTRACT FROM AUTHOR]