Laslett Mark
Director of Clinical Services, PhysioSouth Ltd, Christchurch, Canterbury, New Zealand.
J Man Manip Ther. 2009;17(2):78-85. doi: 10.1179/106698109790824749.
The acute onset lumbar lateral shift, otherwise known as a list or acute scoliosis, is a common clinical observation associated with low back pain. In general orthopaedics, the presence of a lateral shift is associated with a poor prognosis; however, a manual correction method devised by McKenzie is claimed to produce rapid reversal of the deformity and reduction in pain. This single-case report presents the details of the McKenzie Mechanical Diagnosis and Treatment (MDT) management of a major right-sided lateral shift, which includes the manual correction technique, self-correction and management, prophylaxis, pain ablation, and rehabilitation to a high level of athletic function, with long-term follow-up at 9 months. The lateral shift is widely accepted as being associated with disc pathology, but the exact mechanism of shift production remains speculative. hypotheses include muscle spasm, avoidance of irritation of a spinal nerve, and space-occupying or space-deficient disc mechanics. The hypotheses used to explain the lateral shift phenomena are discussed. (Case report is supplemented by video stream, available at jmmtonline.com/).
急性发作的腰椎侧移,也称为脊柱侧凸或急性脊柱侧弯,是与腰痛相关的常见临床现象。在普通骨科中,侧移的存在与预后不良相关;然而,麦肯齐设计的一种手法矫正方法据称能使畸形迅速逆转并减轻疼痛。本单病例报告介绍了对一例严重右侧侧移进行麦肯齐力学诊断与治疗(MDT)的详细情况,包括手法矫正技术、自我矫正与管理、预防、疼痛消除以及恢复到高水平运动功能,并进行了9个月的长期随访。侧移被广泛认为与椎间盘病变有关,但侧移产生的确切机制仍属推测。假说包括肌肉痉挛、避免刺激脊神经以及椎间盘的占位或空间不足力学机制。文中讨论了用于解释侧移现象的假说。(病例报告配有视频流,可在jmmtonline.com/获取)