Chiropractic management of a Veteran with persistent spinal pain syndrome-2 status-post L3-L5 laminectomy and Coflex interlaminar stabilization: a case report.

BACKGROUND

Coflex interlaminar stabilization (CIS) is a second-generation interspinous implant that promotes intersegmental flexion following decompression for moderate to severe lumbar spinal stenosis. We describe the management of a patient with persistent spinal pain syndrome-2 (PSPS-2) status-post CIS implant presenting to a chiropractor's office.

CASE PRESENTATION: A 77-year-old Hispanic male Army veteran presented with PSPS-2 status-post L3-L5 laminectomy and CIS for lumbar spinal stenosis. A 4-visit trial care plan ensued with flexion-distraction manipulation, drop-assist spinal manipulation, patient education, and repeated lumbar flexion-based stretches. No adverse events occurred. On re-evaluation, the numeric pain rating and Oswestry Disability were unchanged.

SUMMARY: We describe the multimodal management of a PSPS-2 patient with a CIS implant presenting to a chiropractic clinic. While no clinically meaningful improvement was observed, no adverse events were reported. Further investigation is needed to evaluate the safety and clinical effectiveness of multimodal manual therapy and exercise-based care in patients with PSPS-2.