NON-SURGICAL - SPINAL DECOMPRESSION REPORT - - DISC HERNIATION

TREATMENT OF AN L5/S1 EXTRUDED DISC HERNIATION USING A DRX9000 SPINAL DECOMPRESSION UNIT: A CASE REPORT

ABSTRACT

Objective: To discuss a case of subacute lumbar disc herniation successfully treated with a DRX-9000 spinal decompression unit.

Clinical Features: A 50-year-old male presented with a chief complaint of severe lower back pain and left sided sciatica persisting for two months. Most orthopedic testing procedures could not be performed due to the severity of pain at the time of presentation. Standard radiographs of the lumbar spine revealed only some moderate disc space narrowing at L5/S1. However, the patient did present a magnetic resonance image (MRI) report with images per- formed one week prior. The lumbar MR images obtained were scanned in a neutral seated (weight-bearing) position using an upright unit. The imaging report was written by a chiropractic radiologist and revealed an L5/S1 left para- central disc herniation (extrusion) causing posterolateral displacement of the left S1 nerve root.

Intervention and Outcomes: The patient was provided spinal decompression treatments following the written protocols for the DRX-9000 unit. Care was provided by various doctors and locations. Relief of symptoms began following the first treatment, and eight weeks of follow-up care provided 100% reduction of symptoms. Neutral seated (weight-bearing) MR images were repeated approx- imately 7.5 months following initiation of treatment. These images revealed complete reduction of the previously visualized L5/S1 discal herniation.

Conclusion: DRX-9000 spinal decompression therapy is believed to provide both biochemical and biomechanical alterations to the disc. The affects of axial spinal decom- pression therapy on this patient’s case could be objectively quantified through pre-therapy and post-therapy MR imag- ing. Spinal decompression applied by means of the DRX- 9000 protocol is an effective resource for treating patients passing through various clinicians without significant inter-operator or examiner variability.

Discogenic pain is derived from nuclear migration causing tearing of the outer annular fibers. Pathological disc bulges (A) generally cause limited canal intrusion, while hernia- tions (B) focally progress into the confines of the spinal canal.

INTRODUCTION

The intervertebral disc tends to degenerate in everyone as part of the aging process. Although this does not inevitably cause back pain it is probably the most common site of spine pain; accounting for up to 85% of cases.1 Relentless research has been applied to determine the exact mecha- nism for disc pain, and although the exact pathophysiology of this has not yet been determined, several hypotheses exist. The most likely mechanism begins with aberrant me- chanical forces causing an inflammatory response and thus stimulating the nocioceptive receptors within the disc.1 The disc itself is made up of two major components, an outer annulus fibrosus and an inner nucleus pulposus. The annulus fibrosus is composed of a fibrocartilaginous series of concentric rings with collagen arranged at a 65 degree angle from the vertical plane.2 Each ring abuts another, with adjacent fiber orientation in the opposite direction, and thus, it has been found to be the primary load-bearing structure of the disc. The nucleus pulposus is the gelati- nous center of the disc. It is avascular and nurtured only from a process known as imbibition. Activity during the day and rest at night is crucial for the pumping of nutrient rich fluid through the vertebral endplate and into the disc.

CONCLUSION

Spinal decompression therapy provided an effective means of treatment for this patients symptoms resulting from discal herniation (extrusion) with associated impingement of the adjacent nerve root. As seen by this case, and supported by research, the apparent affects of spinal de- compression therapy are quick to prevail, generally occurring within 10 treatments.21 It is inferred from this study the effects of spinal decompression via the DRX-9000 are multifactorial, affecting both the biomechanics as well as the pathophysiology of the disc. The immediate relief of symptoms in this patient suggests a reduction of inflamma- tory infiltrates affecting the nocioceptive fibers; while the decompressive forces to the disc allowed increased imbibition and complete reduction of the visualized extruded herniation.

MR imaging proved to be a useful and non-invasive tech- nique in monitoring the efficacy of decompression therapy as it applies to this case. The standardized protocols employed by the operators of the utilized decompression units may have contributed to the favorable results seen. The lack of uniformity in treatment techniques has been suggested as an area of error for past clinical trials.11 Decompression of the spine proved to be superior to the other forms of conservative care when applied to our patient. The patients’ results were both subjectively favorable and objectively quantified.

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For more information see also:

Spinal Decompression Treatment