Case History: Patient with Lower Back Disc Injuries
Mr. B. is a 47 year old male factory worker that attended the Practice with acute debilitating lower back pain and disability. His diagnosis was that of lower back disc injuries (L3, L4 and L5). He was suffering chronic spinal pains, mid back and lower back pain with associated myofascial (muscle) weakness in the lumbopelvic region.
He could not work, walk, sit or sleep without significant sharp and stabbing pains into the lower back, aching and weakness in to the legs. Prior to attending the Clinic the patient had a series of cortisone injections into the spine with little effect. He was using Lyrica and Panadene.
The patient had been referred to a surgeon in preparation of the lower back disc removal and fusion. The patient was informed the surgery would cost approximately $100,000.00. He attended the Practice for a second opinion.
This is the result of his care for lower back disc injuries:
These are the Posture Screen Views, the digital postural assessment, conducted as part of all new patient evaluation. The view on the left is the patient prior to commencing care. The view on the right is the patient after completing a corrective care program.
The green line is the vertical axis line (or y axis). Clearly the patient translates to the right (x axis translation). Significant improvement is seen in the before and after views.
Although the patient had disc injuries in the lower back, he was experiencing diffuse spinal pains and disability. He had neck pains, headaches and decreased range of motion in all planes of movement in the neck. The vast majority of the pain and disability cleared by the progress evaluation.
The first X-ray on the left, prior to care, shows the patient head shifted 3.9 mm to the left. There was a mid neck tilt angle of 8.4 degrees to the left and lower neck tilt angle of 2.1 degrees to the right.
The follow up X-ray on the right, after the completion of 40 visit program shows the head is now shifted to the right 2.1 mm. There is a mid neck tilt angle of 1.7 degrees to the left and a lower neck tilt of 1.6 degrees to the right.
The neck series shows good correction of the cervical due to compensatory changes driven by the lower back. A great outcome for the patient.
Due to the disc injuries in the lower back, the patient is obviously antalgic; which means they are leaning to the side as a result of the pains. However the patient had been ‘stuck’ in this position for many months and was part of his postural and biomechanical imbalance.
The first X-ray on the left (prior to care shows) a mid back shift 29.4 mm to the right and mid lower back tilt angle of 7.3 degrees.
The second X-ray, following a Corrective Care protocol shows the mid back shift has removed to 12.0 mm and the mid lower back tile angle is 2.9 degrees. That is a reduction of 17.4 mm!!
Nice result for the patient with decreased loading of hip and knee on the right. Remember most of the body weight is carried in the torso. It is very important to have correct alignment though the mid back.
Ok, so this is the side view of the lower back showing significant forward translation of the spine and rib cage. Forward translation (+TzL) in the Z axis creates enormous pressure on the disc and facet joints of the lower back, the hamstrings and calves. The patient has an old disc injury at L5 which is close to ‘bone on bone’. The next two discs; L3 and L4 are quite swollen in the initial view, which were the current prolapses and due for fusion.
The first X-ray shows the rib cage is position 47.7 mm forward relative to the pelvis. The lower back curve measures 26.8 degrees and should be 40 degrees. Following a Corrective Care program the rib cage is positioned 2.4 mm forward relative to the pelvis and the lower back curve measures 33.3 degrees.
This is a fantastic result for a lower back disc injury. There is a reduction of translation from 47.7 mm to 2.4 mm!! Note also the Retrolisthesis at L1 (backward translation of L2 relative to L2) has also improved. A large retrolisthesis indicates another disc prolapse was quite likely given the altered biomechanics. Both back surgery and a further disc prolapse have been avoided with Corrective Care.
This Is Not a Testimonial.
Disclaimer: This is a Case Study of a real patient who attended the Practice.
As part of the Chiropractic BioPhysics Advanced Training Protocols, we will be collecting and writing up case studies of patients within the Practice. It is the only way to show the very real and measurable changes we see in patients under care.
Once sufficient case studies have been acquired, and in submission through CBP Seminars advanced training, we will look to publish these studies in peer reviewed journals where appropriate.
The Australian Health Practitioner Regulation Agency (AHPRA) forbids the use of testimonials in Australia. This is not a testimonial. There is no guarantee of outcome in treating complex neurological and spinal conditions such as those presented in the Case Study.
In keeping with the regulations of the Authority, we provide this case for your interest as an example of the type of patient we regularly assist within the Clinics.
If you like this article be sure to visit the Spinal Centre website at www.thespinalcentre.com.au and view more content by Dr. Hooper and the Spinal Rehabilitation Team.
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