Journal of Back and Musculoskeletal Rehabilitation - Volume 28, issue 3

Authors: Stappers, Jeroen | Herregods, Piet | Chappel, Rudi | Surgeloose, Didier De | Stassijns, Gaëtane

Article Type: Case Report

Abstract: We report the case of a 53-year-old male with a right Achilles tendinosis, who complains about a mild gait disorder starting after walking several kilometers. In the following months he develops neurological symptoms. MRI lumbar spine shows an intramedullary tumor at level Th12. A biopsy confirms the diagnosis of an intramedullary astrocytoma. Primary intramedullary tumors are relatively rare. Clinical presentation is often insidious. The authors want to make a point to reconsider a diagnosis in case it does not explain completely the anamnestic or clinical findings. According to the literature there is no optimal approach to the management of these …tumors. Show more

Keywords: Astrocytoma, intramedullary tumor, meningeal spread, tendinosis

DOI: 10.3233/BMR-140542

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 3, pp. 599-602, 2015

Authors: Alagha, Babak

Article Type: Case Report

Abstract: BACKGROUND: Disc herniation is one of the most common causes of low back pain with radicular pain. Among various types of disc herniation, the extraforaminal disc herniation is a rare cause of lumbar radiculopathy. The aim of presenting this case study is to demonstrate the benefits of Chiropractic care including spine and extremity manipulation and rehabilitation in the treatment of a rare case of extraforaminal L4 nerve entrapment causing severe L4 radiculopathy and chronic mild low back pain (LBP). OBJECTIVE: The aim of presenting this case study is to demonstrate the benefits of Chiropractic care …including spine and extremity manipulation and rehabilitation in treatment of rare case of extraforaminal L4 nerve entrapment which caused severe L4 radiculopathy and chronic mild low back pain (LBP). METHOD: A 45-year old female patient arrived at the clinic with chronic mild low back pain and right buttock pain, all of which had presented for two years' duration. During the preceding month, the radicular pain initiated in medium to high intensity, radiating to her right leg following the L4 dermatomal pattern with a periodic tingling sensation in her right foot. A neuro exam demonstrated a proprioception deficit in her right leg. A Romberg test was positive. The patient was treated by low amplitude high velocity spinal and extremity manipulation for 10 consecutive sessions (2 weeks), followed by rehabilitation and exercise therapy including advanced myofascial release therapy for an additional 12 sessions (4 weeks). RESULTS: After treatment, the patient reported a significant improvement in her low back pain and radiculopathy. In addition, she achieved some improvement in balance. CONCLUSION: It seems that Chiropractic care and rehabilitation therapy may be a safe and effective modality in treatment of an L4 radiculopathy in a patient with an extraforaminal L4 nerve entrapment. Although it is rare, an L4 extraforaminal disc herniation should be considered as a possible cause of symptoms in patients with chronic mild low back pain and severe L4 radiculopathy. Show more

Keywords: Chiropractic care, L4 extraforaminal nerve entrapment, L4 radiculopathy, low back pain, extraforaminal disc herniation

DOI: 10.3233/BMR-140557

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 3, pp. 603-607, 2015