Lumbar spondylolisthesis affects ~20% of the US population and causes spine-related pain and disability.
This series reports on three patients (two females and one male) aged 68-71 years showing ...improvements in back pain, quality of life (QOL), and urinary dysfunction following correction of lumbar spondylolistheses using CBP
spinal rehabilitation. Pre-treatment radiographs showed lumbar hyperlordosis (-49.6°, ideal is -40°) and anterolisthesis (14.5 mm, ideal is 0 mm). Pre-treatment patient-reported outcome measures (PROMs) included a numeric rating scale (NRS) for back pain (7.3/10, ideal is 0), urinary urgency (8/10, ideal is 0), and SF-36 physical (PCS) and mental component score (MCS) (29.8 and 46.6, ideal is 46.8 and 52.8). Patients underwent 2-3 CBP
sessions per week to correct lumbar hyperlordosis and lumbar anterolistheses.
Post-treatment radiographs showed improvements in lumbar curvature (-42.8°) and anterolisthesis (4.2 mm). Post-treatment PROMs showed improvements in NRS for back pain (1/10), urinary urgency (2.3/10), and SF-36 PCS and MCS (50.2 and 57.7). Long-term follow-up radiographs and PROMs showed maintained improvements.
This series documents the first-recorded long-term corrections of lumbar spondylolisthesis and concomitant improvements in back pain, urinary urgency, and QOL using CBP
. This series provides evidence for CBP
as a non-surgical approach to lumbar spinal rehabilitation and the possible impacts of spinal alignment on pain, urinary dysfunction, and QOL.
Plain Radiography of the spine (PROTS) is utilized in many forms of healthcare including the chiropractic profession; however, the literature reflects conflicting opinions regarding utilization and ...value. Despite being an essential part of Evidence-Based Practice (EBP), few studies assess Doctors of Chiropractic (DCs) clinical opinions and experience regarding the utilization of (PROTS) in practice. In this study, DCs were surveyed regarding utilization of PROTS in practice. The survey was administered to an estimated 50,000 licensed DCs by email. A total of 4301 surveys were completed, of which 3641 were United States (US) DCs. The Clinician Opinion and Experience on Chiropractic Radiography (COECR) scale was designed to analyze survey responses. This valid and reliable scale demonstrated good internal consistency using confirmatory factor analysis and the Rasch model. Survey responses show that 73.3% of respondents utilize PROTS in practice and 26.7% refer patients out for PROTS. Survey responses show that, among US DCs, 91.9% indicate PROTS has value beyond identification of pathology, 86.7% indicate that PROTS is important regarding biomechanical analysis of the spine, 82.9% indicate that PROTS is vital to practice, 67.4% indicate that PROTS aids in measuring outcomes, 98.6% indicate the opinion that PROTS presents very low to no risk to patients, and 93.0% indicate that sharing clinical findings from PROTS studies with patients is beneficial to clinical outcomes. The results of the study indicated that based on clinical experience, the majority of DCs find PROTS to be vital to practice and valuable beyond the identification of red flags.
To report improvements in post-concussion syndrome and concussion incidence following cervical spinal alignment correction.
A 27-year-old professional rugby player with 20 documented concussions ...presented with abnormal cervical spinal alignment and post-concussion syndrome. After 30 sessions of cervical rehabilitation, health outcomes improved. Post-treatment radiographs showed improved cervical lordosis from -13.5° to -37.4° (ideal is -42°) and right head translation from -22.7 to -11.3 mm (ideal is 0 mm). 2-year follow-up radiographs and 6-year follow-up health outcomes showed post-treatment improvements were maintained. The patient reported two documented concussions in the 6 years following treatment while maintaining the same lifestyle and professional rugby career.
Correction of abnormal cervical spinal alignment may help athletes with post-concussion syndrome and reduce risk of concussion.
A 27-year-old male professional rugby player with a 6-year history of 20 documented concussions presented with severe neck and headache pain and disability. X-rays of his neck were taken to measure spinal alignment and posture. Also, neck and headache pain, disability and quality-of-life measures were assessed. After 30 treatment sessions of Chiropractic BioPhysics
(CBP
) neck spinal alignment and posture rehabilitation, neck and headache pain and disability and quality-of-life improved. X-rays showed improved spinal alignment and posture in his neck. Follow-up x-rays 2 years after treatment showed that the improvements to his neck spinal alignment and posture were maintained. Follow-up assessment 6 years after treatment showed that the post-treatment improvements in in neck and headache pain and disability and quality of life were maintained. Additionally, the patient reported only two documented concussions in the 6 years following treatment maintaining the same lifestyle and competing as a professional rugby player at the same level, position and playing time. This is the first documented improvement in post-concussion syndrome and decreased concussion occurrence following correction of neck spinal alignment and posture. Correction of neck spinal alignment and posture allows the spine to function as a healthy shock absorber and increases its ability to decrease stress transferred to the brain from trauma responsible for concussions and may reduce the risk of concussions.
Improvements in post-concussion syndrome neck and headache pain and disability and concussion incidence in a professional rugby player following correction of abnormal spinal alignment and posture using Chiropractic BioPhysics
Mirror Image
structural spinal rehabilitation.
Purpose To report on the reduction of a double lumbar spine spondylolisthesis by use of Chiropractic BioPhysics® technique. Participant and Methods A 57 year-old male presented with severe chronic ...low back pains and sciatica. After playing hockey for 50 years, he was unable to continue and was forced to retire. Lumbar radiography showed an L3 retrolisthesis of −5.3 mm and an L4 anterolisthesis of 5.4 mm. Chiropractic BioPhysics technique including mirror image lumbar spine drop-table adjustments, corrective exercises and a unique pelvic extension traction was performed 50 times over 7-months. Results A radiograph after 3-months showed full reduction of the L3 retrolisthesis. A radiograph after 7-months showed full reduction of the L4 anterolisthesis. The patient reported full resolution of chronic back pains and was able to return to play hockey; a 1.75 year follow-up showed maintenance of the corrections and the patient remained injury-free while returning to play hockey. Conclusion A customized treatment program including Chiropractic BioPhysics lumbar spine traction, corrective exercises and drop-table spine manipulation resolved chronic back pains and fully reduced an L3 and L4 retro- and antero-listhesis, respectively. Further research may substantiate this treatment approach for reducing translational displacements in the lumbar spine. Routine upright radiography is required to diagnose spondylolisthesis.
Discuss the use of non-surgical spinal rehabilitation protocol in the case of a 69-year-old female with a grade 2 spondylolisthesis. A selective literature review and discussion are provided.
A ...69-year-old female presented with moderate low back pain (7/10 pain) and severe leg cramping (7/10 pain). Initial lateral lumbar x-ray revealed a grade 2 spondylolisthesis at L4-L5 measuring 13.3 mm.
The patient completed 60 sessions of Mirror Image® spinal exercises, adjustments, and traction over 45 weeks. Post-treatment lateral lumbar x-ray showed a decrease in translation of L4-L5 from 13.3 mm to 2.4 mm, within normal limits.
This case provides the first documented evidence of a non-surgical or chiropractic treatment, specifically Chiropractic BioPhysics®, protocols of lumbar spondylolisthesis where spinal alignment was corrected. Additional research is needed to investigate the clinical implications and treatment methods.
Discuss non-surgical spinal rehabilitation for a 27-year-old male with thoracic and lumbosacral spondylolistheses. A selective literature review and discussion are provided.
A 27-year-old male ...presented with severe, 8/10 mid and low back pain. Initial lateral thoracic and lumbar x-rays revealed grade 1 spondylolistheses at T9-T10 and L5-S1 measuring -5.3 mm and -6.8 mm.
The patient completed 60 sessions of Mirror Image® spinal adjustments, exercises, and traction over 30 weeks. Post-treatment x-rays showed correction in translations at T9-T10 and L5-S1 from -5.3 mm to 0.0 mm and -6.8 mm to -1.0 mm, within normal limits. 1-year follow-up x-rays showed maintained correction.
This case is the first documented evidence of non-surgical or chiropractic treatment for thoracic and lumbosacral spondylolistheses where spinal alignment was corrected. More research is needed to investigate the clinical implications and applications.
Loss of cervical lordosis is associated with decreased vertebral artery hemodynamics.
The aim of this study is to evaluate cerebral blood flow changes on brain magnetic resonance angiogram (MRA) in ...patients with loss of cervical lordosis before and following correction of cervical lordosis.
This study is a retrospective consecutive case series of patients in a private practice.
Cervical lordosis of seven patients (five females and two males, 28-58 years) was measured on lateral cervical radiographs ranging from -13.1° to 19.0° (ideal is -42.0°). Brain MRAs were analyzed for pixel intensities representing blood flow. Pixel intensity of the cerebral vasculature was quantified, and percentage change was determined.
A Student's t-test established significance of the percentage change in cerebral blood flow between pre- and postcervical lordosis adjustment images. Regression analysis was performed. An
analysis determined correlation between cervical lordosis and change in MRA pixel intensity. The statistician was blinded to the cervical lordosis.
Pixel intensity increased 23.0%-225.9%, and a Student's
-test determined that the increase was significant (
< 0.001). Regression analysis of the change in pixel intensity versus the cervical lordosis showed that as the deviation from a normal cervical lordosis increases, percentage change in pixel intensity on MRA decreases.
These results indicate that correction of cervical lordosis may be associated with an immediate increase in cerebral blood flow. Further studies are needed to confirm these findings and understand clinical implications.
Abstract. Purpose To report on the reduction of a double lumbar spine spondylolisthesis by use of Chiropractic BioPhysics(R) technique. Participant and Methods A 57 year-old male presented with ...severe chronic low back pains and sciatica. After playing hockey for 50 years, he was unable to continue and was forced to retire. Lumbar radiography showed an L3 retrolisthesis of -5.3 mm and an L4 anterolisthesis of 5.4 mm. Chiropractic BioPhysics technique including mirror image lumbar spine drop-table adjustments, corrective exercises and a unique pelvic extension traction was performed 50 times over 7-months. Results A radiograph after 3-months showed full reduction of the L3 retrolisthesis. A radiograph after 7-months showed full reduction of the L4 anterolisthesis. The patient reported full resolution of chronic back pains and was able to return to play hockey; a 1.75 year followup showed maintenance of the corrections and the patient remained injury-free while returning to play hockey. Conclusion A customized treatment program including Chiropractic BioPhysics lumbar spine traction, corrective exercises and drop-table spine manipulation resolved chronic back pains and fully reduced an L3 and L4 retro- and antero-listhesis, respectively. Further research may substantiate this treatment approach for reducing translational displacements in the lumbar spine. Routine upright radiography is required to diagnose spondylolisthesis.
This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis.
29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior ...head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion.
Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain's to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01).
This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.
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