A Structural Approach to Post-Surgical Laminectomy: A Case Study
Paul A. Oakley, MSc, DC, Robert H. Berry, DC, Deed E. Harrison, DC
Journal of Vertebral Subluxation Research ~ March 19, 2007 ~ Pages 1-7
Objective: Case report of a patient, having persistent low back and leg pain following a L4-L5 surgical laminectomy, who underwent Clinical Biomechanics of Posture (CBP) protocol designed to correct postural distortions.
Clinical Features: A thirty-five year-old male suffered from low back/leg pain following a work injury despite having a lumbar spine laminectomy 6 months prior to chiropractic care. Radiographic analysis revealed a 16mm left lateral thoracic translation and a 47mm forward head translation with loss of the cervical lordosis. Generalized decreased lumbar range of motion and multiple positive orthopedic and neurological tests were present.
Intervention and Outcome: The patient received 36 protocol, over the course of 12 weeks with totalÒtreatments, utilizing CBP correction of a thoracic translation, as well as a significant reduction in forward head posture, resulting in alleviation of positive orthopedic tests. Post examination at 9 months indicated that the improvements in thoracic translation, forward head posture, and cervical lordosis had been maintained. The changes in structure and function appear to be related to the correction of both the thoracic and cervical postural aberrations and the concomitant reduction in the pons-cord tract pathological tension.
Conclusions: A post-surgical laminectomy patient was successfully treated with CBP® protocol, achieving a significant reduction in symptoms not obtained following recent surgery. Normalization of posture resulted in the elimination of positive orthopedic and neurologic tests. A 9-month follow-up examination revealed preservation of both the postural correction and patient health and wellbeing. These results indicate that the correction of thoracolumbar and cervical deformity following surgical laminectomy is achievable and may be a desirable clinical outcome.
Key Words: Post-Surgical Laminectomy, Lumbar Traction, Trunk List, Thoracic Translation, Chiropractic Adjustment, Subluxation.