New York Chiropractic and Physiotherapy Centre, Hong Kong SAR, China.
J Med Life. 2022 Jun;15(6):871-875. doi: 10.25122/jml-2021-0419.
The purpose of this case report was to describe chiropractic management of acute lumbar disc herniation in a patient with a large abdominal aortic aneurysm. A 72-year-old male patient presented with low back pain and right lower leg numbness for 12 months. A review of full-spine X-ray and lumbar MRI revealed moderate spondylosis at L2-5, moderate lumbar scoliosis, and a 7.15 cm abdominal aortic aneurysm (AAA). Given the minimum 2-weeks of referral waiting time to receive treatment for AAA, the patient received chiropractic treatment with a hybrid rehabilitation to address the disc herniation causing severe physical disability. Through the treatments, the patient's pain was significantly alleviated with careful consideration of potential risk factors associated with AAA. In addition, the acute disc herniation was successfully managed by a series of chiropractic treatments before and after the operation for AAA. This case supports that low back pain in patients with AAA can be managed by manual therapy, in contrast to a widespread belief that manual therapy is contraindicated in AAA. More case reports of AAA patients with low back pain are warranted to assess the effectiveness and safety of manual therapy along with surgical treatment for AAA.
本病例报告旨在描述一位患有巨大腹主动脉瘤的患者接受脊医治疗急性腰椎间盘突出症的情况。一位 72 岁男性患者因腰痛和右小腿麻木 12 个月就诊。全脊柱 X 线和腰椎 MRI 检查显示 L2-5 节段中度颈椎病，中度腰椎侧凸，腹主动脉瘤（AAA）7.15 厘米。由于转诊治疗 AAA 需要至少 2 周的等待时间，患者接受了脊医治疗和混合康复治疗，以解决导致严重身体残疾的椎间盘突出症。通过治疗，患者的疼痛明显减轻，同时仔细考虑了与 AAA 相关的潜在风险因素。此外，通过一系列的脊医治疗，在 AAA 手术前后成功地治疗了急性椎间盘突出症。该病例表明，对于 AAA 患者的腰痛可以通过手法治疗来治疗，这与普遍认为手法治疗在 AAA 中禁忌的观点相反。需要更多的 AAA 合并腰痛患者的病例报告来评估在 AAA 手术治疗的同时，手法治疗的有效性和安全性。
