Document Detail

Use of lumbosacral region manipulation and therapeutic exercises for a patient with a lumbosacral transitional vertebra and low back pain.
MedLine Citation:
PMID:  16001908     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Case report. BACKGROUND: A lumbosacral transitional vertebra (LTV) is a congenital anomaly that occurs in 3% to 21% of people with and without low back pain (LBP). There is lack of agreement in the literature as to whether or not the presence of a LTV may cause LBP. The objective of this case report is to present the use of lumbosacral region manipulation and therapeutic exercises on a patient with a known LTV and LBP. CASE DESCRIPTION: In this case report, an active-duty US Army soldier was referred to physical therapy with right-sided LBP and a lumbar radiograph showing a hemisacralized transitional L5 vertebra on the same side as his pain. The patient was treated with lumbosacral region manipulation and flexion exercises aimed at regaining total spinal motion and reducing pain. The patient responded favorably to spinal manipulation and exercise and was discharged from physical therapy after 4 visits. A modified Oswestry Low Back Pain Disability Questionnaire and inclinometer were used to measure outcome after physical therapy intervention. OUTCOMES: After a 2-week period of treatment in physical therapy, the patient improved from an initial Oswestry score of 32% to a score of 4%. Forward bending and left side bending improved from 74 degrees to 140 degrees and from 21 degrees to 45 degrees, respectively. DISCUSSION: Lumbosacral region manipulation along with therapeutic exercises appears to have been an effective treatment approach for this patient with LBP associated with a type IIA LTV.
Alexander Karl Brenner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  35     ISSN:  0190-6011     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-07-08     Completed Date:  2005-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-76     Citation Subset:  IM    
Physical Therapy Services, US Army Vicenza Health Clinic, Vicenza, Italy.
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MeSH Terms
Congenital Abnormalities / classification
Exercise Therapy*
Health Status Indicators
Low Back Pain / rehabilitation*
Lumbar Vertebrae / abnormalities*,  radiography
Manipulation, Spinal*
Physical Examination

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