Maddalozzo Gianni F, Aikenhead Kristine, Sheth Vani, Perisic Michelle N
School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon.
Illinois Back Institute, Wheaton, Illinois.
J Chiropr Med. 2018 Dec;17(4):256-263. doi: 10.1016/j.jcm.2018.03.007. Epub 2019 Jan 25.
The purpose of this retrospective case report was to describe chiropractic management of a patient with failed back surgery syndrome.
A 45-year-old woman presented 2 years after L4-L5 and L5-S1 fusion surgery with low back and sciatic pain. Her physical exam included a positive straight leg raise and diminished lower-extremity reflexes and muscle strength. The patient's magnetic resonance imaging showed right disc bulging and annular tearing at L2-L3 and L3-L4 disc bulging with foraminal impingement.
A total of 52 treatments were provided over 28 weeks consisting of multidirectional functional decompression (FD) unweighted gait training, core exercises while in FD, strengthening exercises on a vibration platform, and supine spinal FD with vibration and chiropractic spinal manipulative therapy. Over the course of treatment, the patient noted gradual improvement in function (Oswestry Disability Index) and pain (Numeric Rating Scale), with a reduction in pain medications. Follow-up of 41 months posttreatment revealed an Oswestry Disability Index score of 0 and Numeric Rating Scale score of 0, and the patient no longer was using any pain medication.
After a course of care, the patient in this study reported resolution of symptoms, decrease in pain medications, and improvement of function.
本回顾性病例报告的目的是描述对一名腰椎手术失败综合征患者的整脊治疗。
一名45岁女性在L4-L5和L5-S1融合手术后2年出现腰背部和坐骨神经痛。她的体格检查包括直腿抬高试验阳性、下肢反射减弱和肌肉力量减弱。患者的磁共振成像显示L2-L3椎间盘右凸和纤维环撕裂，L3-L4椎间盘凸出并伴有椎间孔受压。
在28周内共进行了52次治疗，包括多方向功能减压（FD）、无负重步态训练、在FD状态下的核心锻炼、在振动平台上的强化锻炼以及仰卧位脊柱FD结合振动和整脊手法治疗。在治疗过程中，患者注意到功能（奥斯维斯特里功能障碍指数）和疼痛（数字评分量表）逐渐改善，止痛药用量减少。治疗后41个月的随访显示，奥斯维斯特里功能障碍指数评分为0，数字评分量表评分为0，患者不再使用任何止痛药。
经过一个疗程的治疗，本研究中的患者报告症状消失、止痛药用量减少且功能改善。
