Sebastian Deepak
Institute of Therapeutic Sciences, Residency in Orthopaedic Physical Therapy, Fellowship in Orthopaedic Manual Physical Therapy, 51008 Richard Drive, Plymouth, MI 48170, USA.
J Bodyw Mov Ther. 2014 Oct;18(4):545-52. doi: 10.1016/j.jbmt.2013.12.009. Epub 2013 Dec 25.
A 36-year-old male experienced left sided back and radiating flank pain, following a fall on his buttock. A detailed medical evaluation ruled out the presence of red flags. Initial examination revealed positive findings of comparable local tenderness over the left T11, T12 and left paraspinal area, and a 2 cm shortening of the left leg. 8 treatment visits for a period of 4 weeks addressed mechanical dysfunction at the T11, T12, lumbar and pelvic region, comprising manual therapy, therapeutic exercise and pain relieving modalities. Reduction of local tenderness, back and radiating flank pain was observed. Additionally, resolution of the persistent apparent shortening of his left leg was observed, following a high velocity thrust (HVT) manipulation of the T11, T12 segments. The vertebral motion segment of T11, T12, the thoracoabdominal nerves, the 12th rib, the quadratus lumborum and the serratus posterior inferior are speculated to be potential symptom mediators. The findings in the case report suggest the lower thoracic region to be included during the evaluation process of back pain, especially when the mechanism of injury is a vertical compression.
一名36岁男性在臀部着地摔倒后，出现左侧背部及放射性胁腹疼痛。详细的医学评估排除了警示信号的存在。初步检查发现左侧T11、T12及左侧椎旁区域有类似的局部压痛阳性体征，且左腿缩短2厘米。为期4周的8次治疗针对T11、T12、腰椎及骨盆区域的机械功能障碍，包括手法治疗、治疗性运动及止痛方法。观察到局部压痛、背部及放射性胁腹疼痛减轻。此外，在对T11、T12节段进行高速推力（HVT）手法操作后，观察到其左腿持续明显缩短的情况得到缓解。推测T11、T12的椎体运动节段、胸腹部神经、第12肋、腰方肌及下后锯肌可能是潜在的症状介质。该病例报告中的发现表明，在背痛评估过程中应包括下胸部区域，尤其是当损伤机制为垂直压缩时。
