HIGHER RISK OF HNP (5X) WITH POSITIVE FAMILY HISTORY
JOURNAL OF BONE & JOINT SURGERY (AMERICAN VOLUME). 1991 Jan;73(1):124-128
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Cox decompression chiropractic manipulation of a patient with postsurgical lumbar fusion: a case report
Received 17 November 2010; received in revised form 11 January 2011; accepted 18 January 2011.
Abstract
Objective
The purpose of this case report is to describe a patient with an L5/S1 posterior surgical fusion who presented to a chiropractic clinic with subsequent low back and leg pain and was treated with Cox decompression manipulation.
Clinical Features
A 55-year-old male postal clerk presented to a private chiropractic practice with complaints of pain and spasms in his low back radiating down the right buttock and leg. His pain was a 5 of 10, and Oswestry Disability Index score was 18%. The patient reported a previous surgical fusion at L5/S1 for a grade 2 spondylolytic spondylolisthesis. Radiographs revealed surgical hardware extending through the pedicles of L5 and S1, fusing the posterior arches.
Intervention and Outcome
Treatment consisted of ultrasound, electric stimulation, and Cox decompression manipulation (flexion distraction) to the low back. After 13 treatments, the patient had a complete resolution of his symptoms with a pain score of 0 of 10 and an Oswestry score of 2%. A 2-year follow-up revealed continued resolution of the patient’s symptoms.
Conclusions
Cox chiropractic decompression manipulation may be an option for patients with back pain subsequent to spinal fusion. More research is needed to verify these results.
* Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana † Lawrence J. Ellison Musculoskeletal Research Center, Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, California.
They performed an MRI after 5 weeks to estimate the disc volume and glycosaminoglycan distribution.
The disc volume increased significantly at 4 weeks after the puncture. The nucleus pulposus (center of the disc) displaced from anulus fibrosus (outer rings of the disc) increased T1 weighting of disc and glycosaminoglycan significantly decreased.
So this all shows that if there is damaged disc, the glycosaminoglycan escapes the damaged disc, and the disc itself changes. What could help the disc? Possibly nutrition and chiropractic flexion distraction?
“Products such as omega-3 essential fatty acids (EFAs) (O3) do have strong scientific support to be considered as an alternative and/or complementary agent to NSAIDs. Published studies have shown the effectiveness of O3 to successfully treat spine-related pain.”
Gregg F. Moses DC
moseschiropractic.com
Interesting article relating Vitamin D3 supplementation to improved lower back pain. Dosage was 4000 t0 5000 IU/daily.
Improvement of Chronic Back Pain or Failed Back Surgery with Vitamin D Repletion: A Case Series
Journal of the American Board of Family Medicine January–February 2009; Vol. 22; No. 1; pp. 69 –74
Gerry Schwalfenberg, MD; from the Department of Family Medicine, University of Alberta, Canada.
KEY POINTS FROM THIS CASE SERIES:
1) This article reviews 6 selected cases of improvement/resolution of chronic back pain or failed back surgery after vitamin D repletion in a Canadian family practice.
2) Chronic low back pain and failed back surgery may improve with repletion of vitamin D from a state of deficiency/insufficiency to sufficiency.
3) Vitamin D insufficiency is common; repletion of vitamin D to normal levels in patients who have chronic low back pain or have had failed back surgery may improve quality of life or, in some cases, result in complete resolution of symptoms.
4) “Back pain is the most common neurological complaint in North America, second only to headache.”
5) “Low back pain (LBP) and proximal myopathy are also common symptoms of vitamin D deficiency and osteomalacia.”
6) In this report, there were 4 patients who had chronic back pain for more than a year and 2 patients who suffered for more than 3 years from failed back surgery.
7) “Repletion of inadequate vitamin D levels (>80 nmol/L) demonstrated significant improvement or complete resolution of chronic LBP symptoms in these patients.”
8) “Vitamin D is required for the differentiation, proliferation, and maturation of cartilage cells and for the production of proteoglycan synthesis in articular chondrocytes.”
9) “Patients who have chronic, nonspecific LBP or have had failed back surgery may have an underlying vitamin D insufficiency/deficiency.”
10) Risk factors for persistence or recurrence of LBP after surgery include infection, smoking and low vitamin D levels.
111) “All patients had tried various pain treatments, including physiotherapy, visiting a chiropractor, acupuncture, or visit to a pain management clinic, all without much benefit.”
12) Physicians should have a high index of suspicion for low vitamin D levels in patients with LBP.
13) “The patients in this study who responded best used between 4000 and 5000 IU of vitamin D3/day.”
14) “This case series supports information that has recently become apparent in the literature about vitamin D deficiency and its influence on back pain, muscle pain, and failed back surgery. Doses in the range of 4000 to 5000 IU of vitamin D3/day may be needed for an adequate response.”
Cox Decompression Technique very effective for treatment of chronic lower back pain and failed back surgery cases.
Check out our redesigned website: moseschiropractic.com
Dr. Gregg F.Moses
1800 Forest Hill Blvd.
Suite A8-10
West Palm Beach, FL 33406
561-641-9211
People who have heard of the Cox Technic often say, “that’s that technique that stretches you” or “that’s that technique for disc herniations”. Well…. yes to both. This is from Dr. Cox’s website and as you can see Cox Technic has benefitted many spinal conditions…
Spinal pain related conditions that may benefit from Cox Technic Flexion Distraction and Decompression may include:
Received 12 February 2002; received in revised form 25 June 2002
Although flexion distraction performed to the lumbar spine is commonly utilized and documented as effective, flexion distraction manipulation performed to the cervical spine has not been adequately studied.
To objectively quantify data from the Visual Analogue Scale (VAS) to support the clinical judgment exercised for the use of flexion distraction manipulation to treat cervical radiculopathy.
A retrospective analysis of the files of 39 patients from a private chiropractic clinic that met diagnostic criteria for inclusion. All patients were diagnosed with cervical radiculopathy and treated by a single practitioner with flexion distraction manipulation and some form of adjunctive physical medicine modality.
The VAS was used to objectively quantify pain. Of the 39 files reviewed, 22 contained an initial and posttreatment VAS score and were therefore utilized in this study.
This study revealed a statistically significant reduction in pain as quantified by visual analogue scores. The mean number of treatments required was 13.2 ± 8.2, with a range of 6 to 37. Only 3 persons required more treatments than the mean plus 1 standard deviation.
The results of this study show promise for chiropractic and manual therapy techniques such as flexion distraction, as well as demonstrating that other, larger research studies must be performed for cervical radiculopathy.
I am very proud to also practice this technique.
Gregg F.Moses, D.C.
moseschiropractic.com