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Luigi Mangione, the 26-year-old man charged with killing UnitedHealthcare CEO Brian Thompson, suffered from a spinal condition.
Mangione's social media accounts included several references to back pain. On X, Mangione's banner included an X-ray image of a spine after a spinal fusion.
On his Reddit account, he posted in a subreddit for spondylolisthesis, a lower back condition most often caused by joint deterioration. Mangione also mentioned he had spondylolisthesis in handwritten notes from 2019 reviewed by Business Insider.
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According to Cleveland Clinic, spondylolisthesis is usually caused by aging (as the discs holding the vertebrae weaken) or injuries.
It is a condition when one of the bones in the spine falls out of alignment and "presses down" on the vertebra below it. That pressure on nearby nerves can cause lower back pain.
Other symptoms include sciatica (nerve pain that runs down from the lower back to the legs), back stiffness, numbness, and difficulty walking.
Not everyone needs spinal fusion surgery to realign their vertebrae; depending on the severity of the symptoms, rest, physical therapy, and wearing a brace can help reduce pain, as can taking over-the-counter medications when symptoms flare up.
In 2022, Mangione moved to a co-living space in Honolulu called Surfbreak. According to a Reddit post, he experienced sciatica, nerve pain that runs down from the lower back to the legs, for the first time after a surf session. "A few weeks later I slipped on a piece of paper and my right glute locked and right leg shut down for a week," he wrote in 2022. "Couldn't support any weight on it."
Prior to his back surgery in 2023, Mangione also described having "near-constant burning/twitching in both ankles/calves" and "back and genital pain" on Reddit — symptoms of sciatica.
R.J. Martin, who owns Surfbreak, told the New York Times that shortly after moving in, Mangione experienced such debilitating pain from a group surfing lesson that he needed Martin to switch out his mattress.
Mangione also told Martin that his condition prevented him from being in a romantic relationship.
"He knew that dating and being physically intimate with his back condition wasn't possible," Martin said. "I remember him telling me that, and my heart just breaks."
At first, the back surgery seemed to improve Mangione's symptoms — he posted in 2023 that it was a "success." But by June 2024, he started criticizing doctors online and eventually lost touch with friends and family.
According to Mayo Clinic, spinal fusion surgeries for spondylolisthesis "can have very good outcomes when performed well and for the right reasons."
