WIRBELSÄULENCHIRURGIE Anamnesis Lumbar Spine Motion ... FÜR FUNKTIONSERHALTENDE WIRBELSÄULENCHIRURGIE…

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    16-Oct-2018

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<ul><li><p>ZENTRUM FR FUNKTIONSERHALTENDE WIRBELSULENCHIRURGIE</p><p>Orthopdie und Neurochirurgie Dr. Michael SchubertDr. Armin Helmbrecht</p><p>APEX SPINE CENTERHelene-Weber-Allee 1980637 Mnchen</p><p>Telefon/Fax: +49 (0)700 20 4000 20 Web: www.apex-spine.comE-Mail: info@apex-spine.com</p><p>Motion preservation spinesurgery</p><p>surname</p><p>city</p><p>fax</p><p>e-mail</p><p>general informations</p><p> first name</p><p> date of birth</p><p> adress</p><p> country</p><p>contact informations</p><p> phone</p><p> mobile</p><p>your pain areas</p><p> Where in your body is the pain located?</p><p>Anamnesis Lumbar SpinePage 1 of 3</p><p>Fax: ++49 (0)700 20 4000 20</p></li><li><p>ZENTRUM FR FUNKTIONSERHALTENDE WIRBELSULENCHIRURGIE</p><p>Orthopdie und Neurochirurgie Dr. Michael SchubertDr. Armin Helmbrecht</p><p>APEX SPINE CENTERHelene-Weber-Allee 1980637 Mnchen</p><p>Telefon/Fax: +49 (0)700 20 4000 20 Web: www.apex-spine.comE-Mail: info@apex-spine.com</p><p>Motion preservation spinesurgery</p><p>Your health complaints</p><p> Since when hve you had the current complaints</p><p> I have back pain yes no </p><p> I have leg pain left right no</p><p> I have pain in my fundament ileft right no</p><p> When I sneeze or cough the pain increases no little yes</p><p> When I lie I have pain no little yes </p><p> When I walk I have pain no little yes</p><p> When I sit I habe pain no little yes</p><p> When I stand I have pain no little yes</p><p> What hurts most sitting standing </p><p> going lying</p><p> Was there a cause for your back/leg problems (e.g. accident, heavy lifting)</p><p> Is there a loss of strength in your leg yes no </p><p> s there a loss of sensation in your leg yes no </p><p> Have you operated on your back yes no </p><p> If so, what kind of operation was that and when did it take place</p><p> What kind(s) of treatment have you had so far and whar was the result</p><p>Anamnesis Lumbar SpinePage 2 of 3</p><p>Fax: +49 (0)700 20 4000 20</p></li><li><p>ZENTRUM FR FUNKTIONSERHALTENDE WIRBELSULENCHIRURGIE</p><p>Orthopdie und Neurochirurgie Dr. Michael SchubertDr. Armin Helmbrecht</p><p>APEX SPINE CENTERHelene-Weber-Allee 1980637 Mnchen</p><p>Telefon/Fax: +49 (0)700 20 4000 20 Web: www.apex-spine.comE-Mail: info@apex-spine.com</p><p>Motion preservation spinesurgery</p><p>Your health complaints</p><p> Did you do any sports before the complaints arose yes no</p><p> If so, what kind of sport</p><p> What is the result/conclusion of the last MRI, MRT or CT</p><p>Anamnesis Lumbar SpinePage 2 of 3</p><p>Fax: +49 (0)700 20 4000 20</p></li></ul>