Chiropractic and rehabilitative management of a patient with progressive lumbar disk injury, spondylolisthesis, and spondyloptosis.

OBJECTIVE

To describe the chiropractic treatment for a patient with low back pain accompanied by sensory and motor deficits of his left leg and magnetic resonance imaging-documented lumbar spinal cord and nerve root impingement.

CLINICAL FEATURES: A 57-year-old man experienced low back pain that radiated into his left leg and subsequently produced both sensory and motor deficits of the left thigh and quadriceps followed by a similar weakness and accompanying paresthesia of the lower left leg. Onsets were sudden and occurred during sleep, after prolonged sitting or during long periods of driving. Diagnostic studies revealed a slight impingement at the L5-S1 level due to anterior displacement of the L5 vertebra and a mild protrusion of the L4 disk.

INTERVENTION AND OUTCOMES: Treatment consisted of chiropractic spinal manipulation, physical therapy modalities, and rehabilitative exercises. Outcome measurements in his case indicated that his rehabilitation was appropriate.

CONCLUSION

There is an abundance of published reports describing treatment of disk injury, low back pain, and spondylolisthesis with a variety of manipulative methods. However, this appears to be the first case reported in indexed literature of a progressive multilevel lumbar disk injury with concomitant spondylolisthesis and spondyloptosis.