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L2/3 region and L3/4 and the worst affected levels appeared to be L4/5 and
L5/S1.
xxxx
I have admitted him for a course on intensive conservative management in
hospital. He has been commenced on pelvic traction and been given pain
medication, which includes Narcotic analgesia, muscle relaxants, and antiinflammatories. I have also commenced him on a course of physiotherapy
and hopefully with this conservative mode of treatment he should show
sufficient improvement to obviate any spinal surgery.[5]
On October 24, 2006, Dr. Govender issued another medical report[6] where he stated
that while Munar’s improved condition allowed him to travel, he would require
assistance in carrying his things and should be lying down for the entire duration of the
trip. Munar should undergo further treatment and management in a spine rehabilitation
facility but if he would not register a positive response thereto, he must undergo
surgery. Specifically:
Mr. Munar is currently recovered from the acute pain syndrome that he first
presented with. Although he has not recuperated completely he has
progressed to the state were he will be able to travel back to the Phillipines
(sic) with assistance. He will require assistance with regard to his baggage
transfers and he should also be accommodated on the aircraft so that he can
lie down, as this would minimize the amount of pressure on his lumbar
inter-vertebral disc and minimize the nerve root compression. It is
reasonable to assume that the heavy lifting that forms part of his daily work
duties has contributed significantly to the abnormalities demonstrated on his
lumbar spine MRI scans. x x x.
Mr. Munar will require further treatment and management in the Philippines.
I would recommend a further course of conservative treatment for a few
more weeks. If this does not settle he may then require surgical intervention
with decompression of the areas of stenosis (narrowing) and removal of the
disc fragments that are compressing the nerve roots and a possible fusion of
his lower back. However, this will depend on the response to the
conservative treatment and his recovery after such surgery may take up to 3
months.[7]
Dr. Govender also declared Munar unfit to perform his usual sea duties:
Whether he has further surgery or not, it will not be possible for Mr. Munar
to continue performing the “heavy manual duties” that [his] job requires any
longer, as this could exacerbate his lumbar spine problem. From this
perspective he is medically unfit to continue such duties. x x x[8]
elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/55508
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