Villafañe Federico E, Harvey Allison, Kettner Norman
Department of Radiology, Logan University, Chesterfield, Missouri.
Department of Chiropractic Health Centers, Logan University, Chesterfield, Missouri.
J Chiropr Med. 2017 Sep;16(3):236-241. doi: 10.1016/j.jcm.2017.02.001. Epub 2017 Apr 7.
The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS).
A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation. Magnetic resonance imaging demonstrated disk protrusion and canal stenosis with tortuosity of the cauda equina consistent with redundant nerve root appearance.
The patient was treated with chiropractic flexion distraction, which was followed by a course of acupuncture and spinal manipulation. The patient self-discharged following clinical improvement.
This case demonstrated CLDCS with associated redundant nerve roots. Conservative treatment included chiropractic diversified lumbar spinal manipulation, acupuncture, and electrical stimulation. The patient self-discharged following clinical improvement in 3 months.
本病例报告旨在描述慢性腰椎管狭窄症(CLDCS)所致神经根冗余的诊断性影像学特征。
一名56岁男性,主诉严重腰痛。在腰椎活动范围极小的情况下即出现疼痛。患者表现为右髂腰肌无力及L-2皮节感觉减退。初步诊断为CLDCS。患者日益加重的严重腰痛促使其接受腰椎磁共振成像检查以作进一步评估。磁共振成像显示椎间盘突出、椎管狭窄以及马尾神经迂曲,符合神经根冗余表现。
患者接受了整脊屈曲牵引治疗,随后进行了一个疗程的针灸和脊柱推拿。患者临床症状改善后自行出院。
本病例显示为伴有神经根冗余的CLDCS。保守治疗包括整脊多元化腰椎脊柱推拿、针灸及电刺激。患者在3个月临床症状改善后自行出院。