Colloca Christopher J, Polkinghorn Bradley S
State of the Art Chiropractic Center, PC, 11011 S. 48th Street, Suite 205, Phoenix, AZ 85044, USA.
J Manipulative Physiol Ther. 2003 Sep;26(7):448-59. doi: 10.1016/S0161-4754(03)00095-2.
To discuss 2 patients with Ehlers-Danlos syndrome seeking chiropractic evaluation and management of their disabling musculoskeletal pain and associated disorders.
Two disabled patients diagnosed with Ehlers-Danlos syndrome had spinal pain, including neck and back pain, headache, and extremity pain. Commonalities among these 2 cases included abnormal spinal curvatures (kyphosis and scoliosis), joint hypermobility, and tissue fragility. One patient had postsurgical thoracolumbar spinal fusion (T11-sacrum) for scoliosis and osteoporosis. The other patient had moderate anterior head translation.
Both patients were treated with mechanical force and manually assisted spinal adjustments delivered to various spinal segments and extremities utilizing an Activator II Adjusting Instrument and Activator Methods Chiropractic Technique. Patients were also given postural advice, stabilization exercises, and postural corrective exercises, as indicated in Chiropractic BioPhysics Technique protocols. Both patients were able to reduce pain and anti-inflammatory medication usage in association with chiropractic care. Significant improvement in self-reported pain and disability as measured by visual analog score, Oswestry Low-Back Disability Index, and Neck Pain Disability Index were reported, and objective improvements in physical examination and spinal alignment were also observed following chiropractic care. Despite these improvements, work disability status remained unchanged in both patients.
Chiropractic care may be of benefit to some patients with connective tissue disorders, including Ehlers-Danlos syndrome. Low-force chiropractic adjusting techniques may be a preferred technique of choice in patients with tissue fragility, offering clinicians a viable alternative to traditional chiropractic care in attempting to minimize risks and/or side effects associated with spinal manipulation. Psychosocial issues, including patient desire to return to work, were important factors in work disability status and perceived outcome.
探讨2例患有埃勒斯-当洛综合征（Ehlers-Danlos syndrome）的患者寻求脊椎按摩评估及对其致残性肌肉骨骼疼痛和相关疾病的治疗。
2例被诊断为埃勒斯-当洛综合征的残疾患者有脊柱疼痛，包括颈部和背部疼痛、头痛及肢体疼痛。这2例病例的共同特点包括脊柱曲度异常（后凸和脊柱侧弯）、关节活动过度及组织脆弱性。1例患者因脊柱侧弯和骨质疏松接受了胸腰椎脊柱融合手术（T11-骶骨）。另1例患者有中度头部前移位。
两名患者均采用机械力及使用Activator II调整器械和脊椎按摩激活法技术对不同脊柱节段和四肢进行手动辅助脊柱调整治疗。根据脊椎按摩生物物理技术方案，还为患者提供了姿势建议、稳定练习及姿势矫正练习。两名患者均能够在接受脊椎按摩治疗的同时减少疼痛和抗炎药物的使用。据报告，通过视觉模拟评分、奥斯维斯特低腰痛残疾指数和颈部疼痛残疾指数测量，患者自我报告的疼痛和残疾状况有显著改善，并且在接受脊椎按摩治疗后，体格检查和脊柱排列也有客观改善。尽管有这些改善，但两名患者的工作残疾状况均未改变。
脊椎按摩治疗可能对一些患有结缔组织疾病（包括埃勒斯-当洛综合征）的患者有益。低力脊椎按摩调整技术可能是组织脆弱患者的首选技术，为临床医生提供了一种可行的替代传统脊椎按摩治疗的方法，以尽量减少与脊柱推拿相关的风险和/或副作用。社会心理问题，包括患者重返工作岗位的愿望，是工作残疾状况和感知结果的重要因素。
