CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 20-year-old
male who fell 45 feet off a roof.  He states that he stepped
back and slipped and fell landing on his back.  He complains
of severe lower back pain and left ankle pain.  He had no
loss of consciousness.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed fracture of lumbar vertebra without mention of spinal cord injury,Pulmonary collapse,Postconcussion syndrome,Accidental fall from or out of building or other structure
Fx lumbar vertebra-close,Pulmonary collapse,Postconcussion syndrome,Fall from building
Admission Date:  [**2185-3-16**]     Discharge Date:  [**2185-3-23**]

Date of Birth:   [**2163-12-11**]     Sex:  M

Service:  NEUROSURGERY

HISTORY OF THE PRESENT ILLNESS:  The patient is a 20-year-old
male who fell 45 feet off a roof.  He states that he stepped
back and slipped and fell landing on his back.  He complains
of severe lower back pain and left ankle pain.  He had no
loss of consciousness.

PHYSICAL EXAMINATION ON ADMISSION:  General:  On physical
examination, he is a pleasant young man in no acute distress.
HEENT:  The pupils were equal, round, and reactive to light.
EOMs full.  Chest:  Clear to auscultation bilaterally.
Cardiac:  S1 and S2.  No murmurs, rubs, or gallops.  Abdomen:
Soft, nontender, nondistended, positive bowel sounds.
Extremities:  No clubbing, cyanosis or edema.  Neurologic:
Awake, alert, and oriented times three.  Cranial nerves II
through XII were intact.  Motor strength was [**4-13**] except for
the left AT and [**Last Name (un) 938**] which were limited by pain.  His
sensation was intact to light touch throughout.  His rectal
tone was positive.  He had positive bulbocavernosus reflex.
His reflexes were 2+ throughout except for his knees which
were unable to be elicited.

HOSPITAL COURSE:  The patient was admitted to the
Neurosurgery Service with an L1 burst fracture with three
column injury.  MRI was without cord compression but mild canal
compromise. He remained
neurologically stable and flat bed rest with log rolling
precautions.

On [**2185-3-16**], he underwent a T11 to L3 fusion with pedicle
screw fixation and iliac bone graft.  Postoperatively, his
vital signs were stable.  He was awake, alert, following
commands.  His strength was [**4-13**] in all muscle groups.  His
incision was clean, dry, and intact.  He was transferred to
the regular floor.

He remained in stable condition with stable vital signs.  His
dressing remained clean, dry, and intact.  He was fitted for
a TLSO brace.  He did have problems with a dropping
hematocrit and did receive transfusion of 2 units of packed
red blood cells for a crit of 22.  Postoperative crit was 30
and then the following day 31.  He was followed by Physical
Therapy and Occupational Therapy and felt to be safe for
discharge to home with outpatient Occupational Therapy for
some cognitive issues, although his head CT on admission was
negative.  We did feel like he was having problems with
[**Name2 (NI) 54979**] syndrome.  He will follow-up with
Neurobehavior, Dr. [**Last Name (STitle) **], in two weeks.

DISPOSITION:   He was discharged to home in stable condition.

FOLLOW-UP:  The patient is to follow-up with Dr.
[**Last Name (STitle) 739**] on [**2185-4-6**] at 3:00 p.m.Obtain AP and lateral
L spine films prior to that. His incision
remained clean, dry, and intact.  He will follow-up for
staple removal on postoperative day number ten.

DISCHARGE MEDICATIONS:
1.  Hydromorphone 2-6 mg p.o.q. four hours p.r.n.
2.  Prescription for outpatient occupational therapy.

CONDITION ON DISCHARGE:  Stable.




                          [**Name6 (MD) 742**] [**Name8 (MD) **], M.D.
                          [**MD Number(1) 743**]

Dictated By:[**Last Name (NamePattern1) 344**]

MEDQUIST36

D:  [**2185-3-23**]  02:09
T:  [**2185-3-25**]  08:07
JOB#:  [**Job Number 54980**]
{'Closed fracture of lumbar vertebra without mention of spinal cord injury,Pulmonary collapse,Postconcussion syndrome,Accidental fall from or out of building or other structure'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 20-year-old
male who fell 45 feet off a roof.  He states that he stepped
back and slipped and fell landing on his back.  He complains
of severe lower back pain and left ankle pain.  He had no
loss of consciousness.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed fracture of lumbar vertebra without mention of spinal cord injury,Pulmonary collapse,Postconcussion syndrome,Accidental fall from or out of building or other structure'}
