Chu Eric Chun-Pu, Zoubi Fadi Al
New York Chiropractic and Physiotherapy Center, 41/F Langham Place Office Tower, Hong Kong, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
AME Case Rep. 2023 Mar 20;7:18. doi: 10.21037/acr-22-76. eCollection 2023.
Post-polio syndrome (PPS) is characterized by new or worsening muscular weakness, atrophy, muscle and joint pain, and muscle fatiguability decades after paralytic poliomyelitis infection.
A 56-year-old man was diagnosed with paralytic poliomyelitis at the age of five, which left him with flaccid paralysis and weakness of the right leg. One year before seeking chiropractic care, the patient saw his primary care physician with neck pain, low back pain, and fatigue. At the time, he had been diagnosed with degenerative spondylosis and was being treated with tricyclic antidepressants, clonazepam, and tramadol. Despite taking the drugs, his spinal pain and fatigability deteriorated, and he acquired head ptosis during the following six months. As a result, he sought chiropractic care for second opinion. Due to the patient's failure to respond to oral analgesics, radiographs were performed, which revealed degenerative spondylosis, cervical flexion deformity, right pelvic drop, and right thoracolumbar scoliosis. The patient met the PPS diagnostic criteria. PPS related isolated neck extensor myopathy (INEM) was impressed. Multimodal intervention including cervical and lumbar manipulation, spinal traction, micro-vibration deep muscle massage, and core muscle training was provided. As a result of 40-month treatment, the patient reported full resolution of physical complaints. Head posture restored, cervical curvature retrieved and pelvic obliquity relatively corrected.
Survivors of paralytic polio are especially vulnerable to developing leg weakness and length discrepancy, pelvic obliquity, asymmetric axial loading, and trunk muscular imbalance. The current case demonstrates a rare myopathy in a patient at post-polio stage, as well as the restoration of neck function with chiropractic intervention.
小儿麻痹后遗症（PPS）的特征是在麻痹性脊髓灰质炎感染数十年后出现新的或加重的肌肉无力、萎缩、肌肉和关节疼痛以及肌肉疲劳。
一名56岁男性在5岁时被诊断为麻痹性脊髓灰质炎，导致右腿弛缓性麻痹和无力。在寻求整脊治疗的前一年，该患者因颈部疼痛、下背部疼痛和疲劳就诊于其初级保健医生。当时，他被诊断为退行性脊柱病，正在接受三环类抗抑郁药、氯硝西泮和曲马多治疗。尽管服用了这些药物，他的脊柱疼痛和疲劳仍恶化，并且在接下来的六个月中出现了头部下垂。因此，他寻求整脊治疗以获得第二种意见。由于患者对口服镇痛药无反应，因此进行了X线检查，结果显示为退行性脊柱病、颈椎屈曲畸形、右骨盆下降和右胸腰段脊柱侧弯。该患者符合PPS诊断标准。印象诊断为PPS相关的孤立性颈部伸肌肌病（INEM）。提供了包括颈椎和腰椎推拿、脊柱牵引、微振动深层肌肉按摩和核心肌肉训练在内的多模式干预。经过40个月的治疗，患者报告身体不适完全缓解。头部姿势恢复，颈椎曲度恢复，骨盆倾斜相对纠正。
麻痹性脊髓灰质炎幸存者特别容易出现腿部无力和长度差异、骨盆倾斜、不对称轴向负荷以及躯干肌肉失衡。当前病例显示了一名处于小儿麻痹后遗症阶段患者的罕见肌病，以及通过整脊干预恢复颈部功能。
