Improved Chronic Low Back Pain, Radiographic Alignment, and Patient Reported Outcomes Following Postural Rehabilitation Protocols: A Case Series of Two Patients with 18- and 26-Months Follow-Up.

Background/Objectives: We describe a case series of two patients with non-specific chronic low back pain (CLBP) and measurable decreased quality of life, who showed improvements after a specific multi-modal conservative spine and postural therapy regimen. CLBP is the leading cause of years lived with disability and disability-adjusted life years. This case series adds observational data to the medical literature on conservative treatment of CLBP and potentially improves diagnostic and treatment understanding of how conservative therapies can benefit patients suffering with CLBP. Methods: Two patients (Patient A: 58-year-old female; Patient B: 43-year-old male) presented with severe CLBP who did not find relief with prior traditional chiropractic manipulation. The patients sought treatment at a spine rehabilitation facility closest to their remote locations in Wyoming, USA. The conservative rehabilitation treatment program consisted of multi-modal therapies to strengthen postural muscles, postural spinal manipulation, and specific Mirror Image® traction. After 36 treatments over 12 weeks in office and home rehabilitation exercises, baseline tests and outcome measures were repeated. Results: Patient-reported objective outcomes, disability indices, and radiographic analysis demonstrated changes at the conclusion of treatment that were maintained at long-term follow-up re-examination. Lumbar lordosis initially changed from -21.8° L1-L5 lordosis to post-treatment -33.6° for patient A and from -22.6° to -42.4° for patient B. Long-term follow-up demonstrated continued resolution of initial symptoms and maintained spine alignment. Conclusions: In these two patients, the described multimodal conservative program was associated with sustained improvements in symptoms, function, and radiographic parameters. This case series adds to prior biomedical literature regarding potential conservative interventions for treating CLBP and abnormal posture. Larger randomized controlled studies are required to evaluate generalizability and relative effectiveness.