Mr. Green, a 37-year-old Trinidadian taxi driver was complaining to his family doctor about lower back pain, which began just after the last carnival. On questioning he told the doctor that he and his friends had a lot of fun participating in recent carnival activities. Mr. Green’s dancing apparently involved excessive movements of his trunk, which led to his lower back problem.
On examination of his back, the doctor noticed moderate tenderness of the lower paravertebral muscles and movements of the lumbar spine were painful and limited. Radiographic study revealed a spina bifida occulta of the 1st sacral vertebra, while an isotope scan of the lumbar vertebrae was normal. A muscle relaxant was prescribed.
Mr. Green’s father often suffered with lower backbone problems, because he had a slipping lumbar vertebra and Mr. Green wondered if he could have a similar problem with his own vertebra, which might lead to his present condition.