Disc Herniation, Protrusion, Bulge
Post-traumatic findings of the spine after
earlier vertebral fracture in young patients. Kerttula LI,
Serlo WS, Tervonan OA, et al. Spine, May 1, 2000:25(9) pp1104-1108.
Fourteen
patients aged 8.8-20.8 years who had a history of wedge-shaped
vertebral compression fracture at least one year prior were
compared to 14 controls. The majority of the children who
had the trauma had disc degeneration and endplate changes
while only one of the 14 in the control group had degeneration
with endplate damage.
Recurrent low back pain and early disc
degeneration in the young. Salminen JJ, Erkintalo MO, Pentti
J et al. Spine 1999; 24(3):1316-21.
Out of 1,503 14 year olds
7.8%, reported recurrent low back pain (LBP). The children
had MRIs at 15 and 18 years of age and were questioned about
their LBP at ages 15, 18 and 22. Those children who showed
signs of disc degeneration at age 15 were 16 times more likely
to report LBP at age 23.
The study concluded: “Individuals
with disc degeneration soon after the phase of rapid physical
growth not only have an increased risk of recurrent low back
pain but also a long-term risk of recurrent pain up to early
adulthood.”
Management of cervical disc herniation with
upper cervical chiropractic care: a case study. Eriksen K.
Journal of Manipulative and Physiological Therapeutics 1998
21(1):51-56.
A 34-year-old man with severe neck, lower back
and radicular pain of 1 year duration had previously received
care from multiple medical specialists with little or no results.
An MRI of the cervical spine demonstrated a C6-C7 herniated
nucleus pulposus. A needle electromyogram examination confirmed
the presence of a C6-C7 radiculopathy with radiculopathic
changes from C4-C7. X-ray analysis showed that the atlas
and axis were misaligned. The patient was adjusted using
Grostic procedures by hand. Within one month there were dramatic
improvements in all subjective and objective findings At
a one year follow-up it was concluded that surgery was not
necessary.
Magnetic resonance imaging and clinical follow-up:
study of 27 patients receiving chiropractic care for cervical
and lumbar disc herniations Ben Eliyahu, DJ.
Journal of Manipulative
and Physiological Therapeutics Vol. 19 No. 19 Nov/Dec 1996.
Twenty-seven
patients with MRI documented and symptomatic disc herniations
of the cervical or lumbar spine were given chiropractic spinal
care, flexion distraction, physiotherapy and rehabilitative
exercises. Post-care MRIs revealed that 63% of the patients
had a reduced or completely resorbed disc herniation. 78% of
the patients were able to return to work in their pre-disability
occupations.
L5 subluxation: a cause of interstitial cystitis.
Hammer W. Dynamic Chiropractic, 1997 (April 7):14.
This is the
case of a 28-year-old male who suffered from urinary frequency,
perineal pain and mild low back and buttock pain. An MRI confirmed
a lateral L5 disc bulge and a fixation at L5/S1. After two
adjustments to the 5th lumbar vertebrae the patient’s
pelvic and urological symptoms disappeared. The paper below
discusses the same condition but because the authors are MDs
they corrected the problems using surgery.
Lumbar nerve root
compression and interstitial cystitis – response
to decompressive surgery. Gillespie, L, Bray R, Levin R.
British Journal of Urology, 1991;68;361-364.
This paper discusses
ten patients with interstitial cystitis (nine females, one
male). MRI revealed nerve compression at L5 and after surgery
the symptoms in 9 of the 10 cleared up.
Reduction of a confirmed
C5-C6 disc herniation following specific chiropractic spinal
manipulation: a case study. Siciliano MA, Bernard TA, Bentley,
NJ. Chiropractic: The Journal of Chiropractic Research and
Clinical Investigation Vol. 8 No. 1 April 1992.
This is the
case of a 39-year-old male cable technician who complained
of right neck and arm pain. He had a football injury 20 years
prior and had some similar, temporary pain at that time. He
now had an aching, deep pain running from the base of his neck
to the right elbow and sometimes running sharply down his arm.
Magnetic resonance imaging (MRI), thermography and Kronamaz
muscle testing apparatus documented a C5-C6 disc herniation.
Under chiropractic care the patient became symptom free and
a later MRI revealed a reduction in the herniation.
Low force
chiropractic care of two patients with sciatic neuropathy and
lumbar disc herniation. Richards GL et al. Am J Chiro Med Mar
1990;3(1):25-32
Two patients with sciatic neuropathy and confirmed
disc herniation received chiropractic care. A follow-up CAT
scan in the first patient revealed complete absence of disc
herniation. A follow up scan in the second case revealed the
continued presence of a silent disc bulge at the L3-4 level
and partial decrease in a herniation at the L4-5 level. The
bulge appeared to have shifted away from the nerve root. Both
patients’ pain
levels decreased from severe to minimal as they regained
the ability to stand, sit and walk for longer periods without
discomfort and lifting also became easier. They were able
to return to full time work capacity at three and nine months
respectively.
Disc regeneration: reversibility is possible in
spinal osteoarthritis. Ressel, OJ. ICA Review March April 1989
pp. 39 -61.
Osteoarthritis has been regarded as a product of “wear
and tear” of the spine. This paper reveals that chiropractic
management of osteoarthritis can lead to its arrest and even
reversal.
Low back pain and the lumbar intervertebral disc:
clinical consideration for the doctor of chiropractic. Troyanovich
SJ, Harrison DD, Harrison DE. Journal of Manipulative and
Physiological Therapeutics, Feb. 1999; vol. 22, no. 2, pp
96-104.
This paper lists various causes of low back pain, noting
what findings in patient histories, physical examinations,
and diagnostic imaging represent "red flags" that
indicate the need for referral to a specialist for surgical
intervention.
After patients are screened for red flags, conservative
treatment should be the first line of treatment for patients
without absolute signs for surgical intervention. The authors
concluded:
Chiropractic management has been shown through multiple
studies to be safe, clinically effective, cost-effective,
and to provide a high degree of patient satisfaction. As
a result, in patients . . . for whom the surgical indications
are not absolute, a minimum of 2 or 3 months of chiropractic
management is indicated.
Reabsorption of a herniated cervical
disc following chiropractic treatment utilizing the atlas orthogonal
technique: a case report. Robinson, G. Kevin. Abstracts from
the 14th annual upper cervical spine conference Nov 22-23,
1997 Life University, Marietta, Ga. Pub. In Chiropractic Research
Journal, Vol. 5, No.1, spring 1998.
A 44 year old man with a
herniated cervical disc as diagnosed by magnetic resonance
imaging (MRI) and adjusted utilizing chiropractic care (atlas
orthogonal technique) is discussed. His symptoms included severe
neck pain, constant burning, left arm pain and left shoulder
pain plus paresthesia in the index finger of the left hand.
Patient also had diminished grip strength on left hand, a hyporeflexive
biceps and triceps on the left as well as a C6 and C7 sensory
deficit on the left. The MRI scan revealed a large left lateral
herniated disc at the C6-7 level.
By the fifth week of care,
the patient’s symptoms
of severe neck, shoulder, and arm pain were completely resolved.
The patient’s numbness and grip strength improved consistently
during the following six months. Comparative MRI obtained
14 months following the initial exam revealed total resolution
of the herniated cervical disc.
Treatment of multiple lumbar
disc herniations in an adolescent athlete utilizing flexion
distraction and rotational manipulation. Hession EF, Donald
GD. J Manipulative Physiol Ther, 1993; 16:185-192.
This is the
case of a 15-year-old high school athlete with acute low back
pain that began after weightlifting in preparation for a football
game. MRI demonstrated disc herniations of the lumbar area.
Chiropractic care resulted in long-term resolution of the symptoms.
Patient returned to playing football.
Correction of multiple
herniated lumbar disc by chiropractic intervention. Sweat R.
Journal of Chiropractic Case Reports. Vol. 1 No. 1 Jan 1993.
This
is the case of a 39 year old patient presenting with severe
pain in his lower back, radiating into the buttocks, the thigh
and his left calf and foot. A herniated nucleus pulposus at
L-4 L-5 and L-5 S-1 was confirmed by Magnetic Resonance Imaging
(MRI) and surgical procedures were recommended. Chiropractic
was begun utilizing the Atlas Orthogonal Percussion Instrument
on the atlas vertebrae. After 4 weeks of care, he showed a
50% improvement and was not using medications. After six months
of care a subsequent MRI radiologist’s
report indicated that a herniation was not present.
Chiropractic
adjustments, cervical traction and rehabilitation correct cervical
spine herniated disc. Breakiron G. Journal of Chiropractic
Case Reports. Vol. 1 No. 1 Jan 1993.
This is the case of a 43
year old female who suffered C5-6 and C6-7 nuclear herniations
as a result of an automobile collision causing whiplash. She
had a reversal of her cervical curve and extensive soft tissue
damage and herniations as seen on magnetic resonance imaging
(MRI). Specific spinal adjustments were administered and a
therapeutic exercise program was prescribed along with cervical
traction and soft tissue rehabilitation. After 6 months, a
repeat MRI revealed that there was a mild posterior bulging
of the C5-6 level in the mid line with no evidence for significant
disc herniation. The C5-6 area appeared normal.
Lumbar intervertebral
disc herniation: treatment by rotational manipulation. Quon,
J.A., Cassidy, J.D., O’Connor,
S.M., & Kirkaldy-Willis, W.H. Journal of Manipulative
and Physiological Therapeutics 1989; 12: 220-227.
A 30 year
old computer technician with an L4-L5 disc herniation had
relief from back and leg pain after rotational adjustments.
Interestingly, there was no change in the pre- and post-CT
scans. Commenting on the type of adjustment performed, the
authors write: “The treatment of lumbar intervertebral
disc herniation by side posture manipulation is both safe
and effective.”
Treatment of lumbar intervertebral disc
protrusions by manipulation. Pang-Fu Kuo P, Loh Z. Clinical
Orthopedics and Related Research, Feb. 1987; 215:47-55.
Out
of 517 patients with protruded lumbar discs, 76.8% had satisfactory
results. It was concluded that manipulation of the spine can
be effective for lumbar disc protrusions.
Lumbosacral disc protrusion:
a case report. Cox J.J Manipulative Physiol Ther, Dec. 1985;
8(4): 261-266.
Lumbar disc herniation: computed tomography scan
changes after conservative treatment of nerve root compression.
Delauche-Cavallier MC, Budet C, Laredo JD, et.al Spine, 1992;
17(8): 927-933.
This paper describes 21 patients with CT scan
diagnosed lumbar disc herniation and nerve root pain. They
began chiropractic care and a follow-up CT scan at least 6
months later showed the herniations reduced or disappeared
in most patients.
Manipulative Therapy and Rehabilitation of
the Locomotor System, second edition, Lewit, K. 1991. Butterworth-Heineman,
Oxford, 272. Quoted in the Chiropractic Report July 1992.
Vol. 6 No.5.
Spinal manipulation has been shown to successfully
resolve disc problems without the need for surgery in most
cases.
Chymopapain, chemonucleolysis and
nucleus pulposis regeneration. A biochemical study. Bradford
DS, Cooper KM, Oegema TR Jr. Spine, and Mar (2): 135-147, 1984.
This
paper discusses the ability of the intervertebral disc to heal
and regenerate itself.
Bourdillon JE, Day EA, Bookhout MR: Spinal
Manipulation, 5th edition. Oxford, England, Butterworth-Heinemann
Ltd, 1992
“There is no doubt that surgery is occasionally
the only satisfactory treatment for those with unequivocal
signs of protrusion, and the more so with extrusion of disc
material. There is also ample evidence in the experience of
most manual practitioners to show that, even in the presence
of such unequivocal evidence, relief may be obtained by conservative
measures including manual intervention.”
Traction and manipulative reduction for the treatment of
protrusion of lumbar intervertebral disc – an analysis
of 1455 cases. Yefu L, Jixiang F, Zuliang L, Zhengian L.
J Traditional Chinese Medicine. 1986; 6:31-3.
This paper documents
1455 cases of lumbar disc protrusion that were reduced by
traction and manipulation.
Re-establishing the intervertebral
disc by decompression. Neugebauer J. Med Welt 1976;27:19.
The
author reports relief in 99% of 30,000 patients with disc protrusion
over a 14-year period
Disc regeneration: reversibility is possible
in spinal osteoarthritis. Ressel, OJ. ICA Review March April
1989 pp. 39 -61.
Osteoarthritis has been universally accepted
as an integral consequence of aging. The condition is considered
to be the product of various pathobiomechanical alterations
in joint function, a “wear and tear” sequelae.
Under chiropractic care this condition may be arrested and
even reversed.
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Koren, D.C.