Successful use of non-invasive methods in true vertebral instability

[Guest guest]

Hi Alon, & All,

 

Alon wrote:

> Please quote a single study that evaluated segmental instability

> treated by laser or any other non-invasive methods. When i say

> segmental instability in mean true instability.

 

Medline has few articles that match Alon's query and those few are not

impressive:

 

Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(8):1161-4.

[Various features of the treatment of patients with radicular

manifestations of lumbar osteochondrosis] [Article in Russian]

Macheret EL, Samosiuk IZ. The authors propose a systematized

complex of pathogenetic treatment intended for patients suffering from

lumbosacral radiculitis associated with unstable intervertebral segments.

This modality includes relaxing massage, acupuncture, therapeutic

physical exercises and spinal muscles electrostimulation with

subsequent corsetting of the lumbar portion of the spine. When the

proposed method was used for treating 52 patients suffering from

lumbosacral radiculitis with unstable intervertebral segments, 47

patients recovered, three showed considerable improvement and only

two subjects displayed no improvement following the treatment. The

above data warrant the introduction of this therapeutic modality into

clinical practice. PMID: 6605013 [PubMed - indexed for MEDLINE]

 

Vopr Kurortol Fizioter Lech Fiz Kult. 2000 Jan-Feb;(1):8-11. [The

rehabilitative therapy of patients with osteochondrosis of the cervical

spine and manifestations of hypermobility bv means of therapeutic

physical exercise] [Article in Russian] Epifanov VA, Shuliakovskii VV.

The problems of cervical spine osteochondrosis with hypermobility are

of great medical and social significance. Physical rehabilitation methods

can improve effectiveness of basic drug therapy. These include

isometric exercises, postisometric muscle relaxation, proprioceptive

neuromuscular facilitation, postural exercises and special massage.

PMID: 11094871 [PubMed - indexed for MEDLINE]

 

Man Ther. 2000 Feb;5(1):2-12. Lumbar segmental 'instability': clinical

presentation and specific stabilizing exercise management. O'Sullivan

PB. School of Physiotherapy, Curtin University of Technology, Selby

Street, Shenton Park, WA, Australia. Lumbar segmental instability is

considered to represent a significant sub-group within the chronic low

back pain population. This condition has a unique clinical presentation

that displays its symptoms and movement dysfunction within the neutral

zone of the motion segment. The loosening of the motion segment

secondary to injury and associated dysfunction of the local muscle

system renders it biomechanically vulnerable in the neutral zone. The

clinical diagnosis of this chronic low back pain condition is based on the

report of pain and the observation of movement dysfunction within the

neutral zone and the associated finding of excessive intervertebral

motion at the symptomatic level. Four different clinical patterns are

described based on the directional nature of the injury and the

manifestation of the patient's symptoms and motor dysfunction. A

specific stabilizing exercise intervention based on a motor learning

model is proposed and evidence for the efficacy of the approach

provided. Copyright 2000 Harcourt Publishers Ltd. Publication Types:

Review Review, Tutorial PMID: 10688954 [PubMed - indexed for

MEDLINE]

 

Orv Hetil. 1996 Jul 28;137(30):1643-6. [Joint hypermobility: frequent

cause of low back pain] [Article in Hungarian] Konrad K. Orszagos

Reumatologiai es Fizioterapias Intezet, Budapest. This paper is

concerned with vertebral hypermobility that is often associated with low

back pain. This is not uncommon the hungarian general population. The

diagnosis of this condition is essentially clinical. The treatment is special

physiotherapy and to learn how to avoid unaesthetic postures through

appropriate muscular control. It is important to recognize this syndrome,

since a firm diagnosis and reassurance may help the patient

considerably and save a great deal of anxiety, medicine, time and

money to the patient and to the National Health Service as well.

Publication Types: Clinical Trial Randomized Controlled Trial PMID:

9019702 [PubMed - indexed for MEDLINE]

 

J Manipulative Physiol Ther. 1995 Jun;18(5):315-21. Comment in: J

Manipulative Physiol Ther. 1995 Oct;18(8):559. Conservative

management of posttraumatic cervical intersegmental hypermobility and

anterior subluxation. BenEliyahu DJ. OBJECTIVE: To discuss the case

of a young male football player who sustained a hyperflexion cervical

injury, including radiographic evidence of intersegmental hypermobility

and translational displacement with cervical hypolordosis and anterior

subluxation. CLINICAL FEATURES: The patient suffered from neck

pain, spasm, limited range of motion and mild sclerogenous referred

arm pain. The results of neurological exams were normal. Radiographs

of the cervical spine revealed cervical hypolordosis, intersegmental

hypermobility and anterior subluxation. MRI was normal, with no

evidence of disk herniation. INTERVENTION AND OUTCOME: The

patient was immobilized for the first 10 days with a cervical collar and

was administered adjunctive physiotherapy. Light cervical manipulative

techniques were added in the subacute stage, as were isometric and

tubing exercises. The patient responded quickly and favorably to care.

Subsequent radiographs revealed a reversal and resolution of the

abnormal findings of the cervical hypolordosis, anterior subluxation and

intersegmental hypermobility that were initially seen. CONCLUSION:

Conservative chiropractic management of hyperflexion injuries may be

useful in reducing clinical symptoms, cervical hypolordosis, anterior

subluxation and intersegmental hypermobility, as seen in follow-up

radiographs. Chiropractic sports physicians have the diagnostic and

therapeutic expertise to manage these types of athletic injuries.

Publication Types: Case Reports PMID: 7673799 [PubMed - indexed

for MEDLINE]

 

Can other Listers locate good references to successful use of non-

invasive methods in true vertebral instability?

 

Best regards,

 

 

Tel: (H): +353-(0) or (M): +353-(0)

 

 

 

 

Ireland.

Tel: (W): +353-(0) or (M): +353-(0)

 

 

 

" Man who says it can't be done should not interrupt man doing it " -

Chinese Proverb

 

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[Guest guest]

Can other Listers locate good references to successful use of non-

invasive methods in true vertebral instability

>>>>>

Phil

As your review shows most commonly instability is treated with exercises.

However, more significant instability does not respond in the majority of

patients. Between my practice and the orthopads i have been working with we have

seen thousands of patients that failed GOOD conservative care. Unfortunately

alot of patients go through poor physical therapy often with no or minimal

rehab. For those patients that good manipulation, acup, laser and good rehab

fail the only alternative i have seen so far that work is injection therapy. If

instability is extreme surgery is the only option.

 

 

 

 

Oakland, CA 94609