Kruse Ralph A, White Bret A, Gudavalli Sharina
Keiser University College of Chiropractic Medicine, West Palm Beach, Florida.
Chiropractic Care, Ltd., Chicago, Il.
J Chiropr Med. 2019 Dec;18(4):311-316. doi: 10.1016/j.jcm.2019.02.001. Epub 2020 Mar 9.
This case report describes the effect of Cox flexion-distraction manipulation on a patient with a symptomatic L4-L5 extruded disc above an L5-S1 spondylolytic spondylolisthesis.
A 40-year-old man presented to a chiropractor with complaints of acute low back pain and stiffness with pain and tingling radiating into the left leg and foot. Plain-film radiography revealed bilateral pars defects at L5, and magnetic resonance imaging revealed the L4-L5 disc extrusion.
Treatment consisted solely of Cox flexion-distraction for a total of 9 visits over a period of 4 weeks. The pain was assessed initially and at the end of care using a numeric scale of 0 to 10. At treatment conclusion, the original low back and radicular-type symptoms were no longer present, and the patient rated the pain as a 0 after an initial pain assessment of 9 on the 0-10 scale. After 10 years, a follow-up examination showed no orthopedic or neurologic deficits and no recurrence of the original symptoms.
This patient responded favorably to the chiropractic treatment provided. Cox flexion-distraction manipulation may be a viable nonsurgical treatment for similar symptomatic individuals with disc extrusions and concurrent spondylolytic spondylolisthesis.
本病例报告描述了Cox屈曲-牵引手法对一名患有L5-S1峡部裂性脊椎滑脱上方有症状的L4-L5椎间盘突出症患者的疗效。
一名40岁男性因急性下腰痛、僵硬，伴有疼痛和刺痛放射至左腿和足部，前来整脊医师处就诊。X线平片显示L5双侧峡部裂，磁共振成像显示L4-L5椎间盘突出。
治疗仅包括Cox屈曲-牵引，在4周内共进行9次就诊。在治疗开始时和结束时，使用0至10的数字评分量表对疼痛进行评估。治疗结束时，原来的下腰痛和神经根型症状不再出现，患者在最初0至10分的疼痛评分为9分后，将疼痛评为0分。10年后，随访检查显示无骨科或神经功能缺损，原症状未复发。
该患者对所提供的整脊治疗反应良好。Cox屈曲-牵引手法对于类似的有椎间盘突出和并发峡部裂性脊椎滑脱的有症状个体可能是一种可行的非手术治疗方法。
