Lumbar Epidural Hematoma after Chiropractic Manipulation for Lower-Back Pain

Neurosurgery ◽  
2007 ◽  
Vol 61 (1) ◽  
pp. E170-E171 ◽  
Author(s):  
Ole Solheim ◽  
Jan V. Jorgensen ◽  
Oystein P. Nygaard
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Spinal Manipulation ◽  
Epidural Hematoma ◽  
Anticoagulation Therapy ◽  
Cauda Equina ◽  
Cervical Region ◽  
Chiropractic Manipulation ◽  
Lower Back ◽  
First Case

Abstract OBJECTIVE Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar epidural hematoma after chiropractic manipulation. CLINICAL PRESENTATION A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an epidural hematoma at the L3 level. INTERVENTION AND TECHNIQUE We performed surgical evacuation of the hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION This is the first case report of a lumbar epidural hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

scholarly journals Back pain in the emergency department: Pathological fracture following spinal manipulation

CJEM ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 307-312 ◽  
Author(s):  
Christopher Skappak ◽  
Erik J. Saude
Keyword(s):  
Emergency Department ◽  
Multiple Myeloma ◽  
Back Pain ◽  
Lower Back Pain ◽  
Spinal Manipulation ◽  
Case Reports ◽  
Spinal Fracture ◽  
Chiropractic Manipulation ◽  
Lower Back ◽  
Multiple Compression

AbstractBack pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks. An initial evaluation with thoracolumbar radiographs revealed no significant findings. Following initial presentation to the family physician, the patient underwent three treatments of spinal manipulation from his local chiropractor, which resulted in worsening lower back pain. A re-examination and new radiographs in the hospital revealed multiple compression fractures and an underlying diagnosis of multiple myeloma. We have explored current literature examining the prevalence of lower back pain, as well as the incidence of spinal fracture following chiropractic manipulation, and have highlighted a potential complication from chiropractic manipulation in a patient with an undiagnosed underlying neoplastic disorder.

scholarly journals The comparison of McMannis traction and intermittent traction both in conjuction with chiropractic spinal manipulation in the management of chronic mechanical lower back pain

1996 ◽  
Author(s):  
◽  
Melanie Jane Palmer
Keyword(s):  
Back Pain ◽  
Range Of Motion ◽  
Lower Back Pain ◽  
Spinal Manipulation ◽  
Lumbar Vertebrae ◽  
The Other ◽  
Chiropractic Manipulation ◽  
Lower Back ◽  
Other Hand

The purpose of this study was to compare the effects of McMannis traction and Intermittent traction, both m conjunction with chiropractic manipulation in the treatment of chronic i.e. longer than four weeks, mechanical lower back pain. It was hypothesised by the author that McMannis traction would be the traction treatment of choice, as it enables the joints of the lumbar vertebrae to be moved through their normal anatomical range of motion while being traeticned axially. In addition this type of traction is more specific and allows the therapist to determine the amount of traction that is being applied to the patient because it is being applied manually. Intermittent traction on the other hand is a motorised non-specific traction and affects several joints at one time (Saunders 1979).

scholarly journals Spinal Intradural, Extramedullary Ependymoma with Astrocytoma Component: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Gene M. Weinstein ◽  
Knarik Arkun ◽  
James Kryzanski ◽  
Michael Lanfranchi ◽  
Gaurav K. Gupta ◽  
...  
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Lower Back Pain ◽  
Low Grade ◽  
Review Of The Literature ◽  
Pathologic Evaluation ◽  
Lower Back ◽  
Spinal Lesions ◽  
First Case ◽  
Intradural Extramedullary

Ependymomas are common spinal lesions, with the vast majority arising in an intramedullary location. Several cases have been described in the literature of ependymomas in an intradural, extramedullary location. The authors present a case of a 56-year-old female who presented with several weeks of lower back pain and weakness. MRI revealed an intradural, extramedullary enhancing mass at L1-L2. The mass was successfully resected surgically. Pathologic evaluation revealed a low grade glioma with components of both ependymoma and pilocytic astrocytoma with MUTYH G382D mutation. Extramedullary ependymomas are very rare tumors. To the authors’ knowledge, this is the first case of ependymoma/astrocytoma collision tumors described in an extramedullary location.

The relative effectiveness of combined spinal manipulative therapy and action potential therapy versus combined spinal manipulative therapy and placebo action potential therapy in the treatment of mechanical low back pain

2000 ◽  
Author(s):  
◽  
Micah Justin Atkinson
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Action Potential ◽  
Lower Back Pain ◽  
Spinal Manipulation ◽  
Spinal Manipulative Therapy ◽  
Current Therapy ◽  
Low Back ◽  
Manipulative Therapy ◽  
Lower Back

Lower back pain represents as a common disorder, with between 60% and 80% of the general population being affected (Kirkaldy-Willis 1992:2). This, apart from just the health aspects, has serious financial implications which are an ongoing concern to industry (Frymoyer 1991: 137). This study was designed to determine the effectiveness of combined spinal manipulation and "Action Potential" therapy versus spinal manipulative therapy and placebo "Action Potential" therapy in the treatment of mechanical lower back pain. It is currently accepted that spinal manipulation is of great benefit in the treatment of lower back pain (Di Fabio 1992), and it appears that "Action Potential Simulation" therapy, a new low-frequency electrical current therapy, would fit the criteria necessary to address the dysfunctional phase of low back pain as set out by the authors such as Kirkaldy- Willis (1988).

scholarly journals Osteoporotic vertebral fracture misdiagnosed as “normal postoperative phenomenon” in post decompression surgery: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li-sheng Hou ◽  
Dong Zhang ◽  
Feng Ge ◽  
Hai-feng Li ◽  
Tian-jun Gao
Keyword(s):  
Back Pain ◽  
Vertebral Fracture ◽  
Lower Back Pain ◽  
Early Stage ◽  
Decompression Surgery ◽  
Spinal Diseases ◽  
Osteoporotic Vertebral Fracture ◽  
Early Recovery ◽  
Lower Back ◽  
First Case

Abstract Background Previous research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling. These are usually considered minor residual symptoms or normal postoperative phenomenon (NPF) in the clinic, occur frequently, and are acknowledged by surgeons worldwide. To the best of our knowledge, we report the first case of a patient who had an osteoporotic vertebral fracture (OVF) misdiagnosed as NPF after she underwent PTED as a result of lumbar disc herniation (LDH). Case presentation A 71-year-old female with Parkinson’s disease who presented with lower back pain radiating to the legs was diagnosed as LDH in L4–5, after which a PTED of L4–5 was performed, with temporary alleviation of symptoms. However, severe lower back pain recurred. Unfortunately, the recurred pain initially misdiagnosed as NPF, in fact, was finally confirmed to be OVF by CT-scan. OVF in the early stage of post-PTED seldom occurs and is rarely reported in the literature. With a percutaneous vertebroplasty, the pain was significantly relieved, and she resumed walking. After 36-weeks of follow-up, the pain improved satisfactorily. Conclusion Doctors should not immediately diagnose a relapse of back pain following PTED as NPF, and hands-on careful physical and imaging examinations are necessary to manage recurring pain rightly and timely.

scholarly journals Transforaminal Epiduroscopic Laser Ablation for Removal of a Postlaminectomy Synovial Cyst: A Case Report

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 209
Author(s):  
Hee Yong Kang ◽  
So Yeon Kim ◽  
Chung Hun Lee ◽  
Sung Wook Park
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Lower Back Pain ◽  
Nd:Yag Laser ◽  
Rating Scale ◽  
Synovial Cyst ◽  
Pain Clinic ◽  
Lower Back ◽  
First Case ◽  
Synovial Cysts

Background: Synovial cysts rarely occur after a laminectomy and are difficult to detect if there are no symptoms; however, they can cause lower back pain or symptoms of radiculopathy. Various methods are used to treat synovial cysts. Here, we will introduce the first case with treatment using the transforaminal epiduroscopic laser annuloplasty (TELA) system. Case report: A 64-year-old female patient visited the pain clinic with lower back pain and pain radiating from the left lower extremity. An MRI T2 image showed a synovial cyst of facet joint origin at the L4–L5 level; the patient had undergone a laminectomy 10 years ago at the same spinal level. The patient rated the pain an 8 on the numerical rating scale (NRS), and pain was reduced after epidural steroid injection, but symptoms recurred a month later. The cyst ablation was performed using the TELA system with a 1414 nm neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser, and after the procedure, pain decreased to 4 points immediately and was reduced to 2 points on the NRS after 1 week. Six months after the procedure, the pain level was measured on NRS 2 and cyst was not recurred in the additional MRI. Conclusion: We introduced the TELA system as a noninvasive therapy for treating synovial cysts. Ablation of cystic necks using a 1414 nm Nd:YAG laser could be a method to prevent cyst recurrence, but long-term follow-up and large scale control studies will be needed to verify the effectiveness of this method.

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