Chiropractic Management of a Symptomatic Patient Who Previously Had Surgery for Cauda Equina Syndrome.

OBJECTIVE

The purpose of this report is to describe the outcomes of chiropractic care for a patient after surgery for cauda equina syndrome.

CLINICAL FEATURES

Following surgery for cauda equina syndrome caused by a herniated lumbar disc at L5/S1, a 28-year old woman presented for chiropractic care with an 18-month history of lower back pain. She had bilateral L5 and S1 dermatome pain and paraesthesia; saddle anesthesia; bilateral leg weakness in the L4, L5, and S1 myotomes; and urinary incontinence.

INTERVENTION AND OUTCOME

The patient received a variety of chiropractic manipulative techniques including cervical and thoracic spine manipulation, instrumented adjustments to the lumbar spine, and drop technique to the sacroiliac joints. Trigger point therapy was performed on the gluteus medius, quadratus lumborum, and piriformis muscles bilaterally. After 12 months, the patient reported a reduction in lower back and radicular leg pain, was able to reduce her use of opioid medications, and experienced improved lower limb function following chiropractic care.

CONCLUSION

The patient responded favorably to a course of chiropractic care for symptoms remaining after surgery for cauda equina syndrome.