Dorsal disc prolapse with myelopathy: physical therapy influence

ABSTRACT

The purpose of this study was to identify the effect of postero-anterior spinal manipulation on dorsal disc prolapse with mild myelopathy; regarding back pain, ROM of lower dorsal trunk flexion and cadence. Ten volunteer's patients participated in the study. Their age ranged from 34 to 48 years, with duration of illness from one to six months. Patients were diagnosed clinically and by MRI as a dorsal disc prolapse. All patients complained of myelopathy with paraparesis with grade 1+ or 2 spasticity according to a modified Ashworth scale. VAS was used to measure local pain intensity. Functional plain X-ray was used to measure ROM of lower dorsal trunk flexion. Cadence was used as a kinematic parameter of gait for those patients. All these evaluation procedures were performed before and at the end of physiotherapy program. Physiotherapy consisted of ultrasound, hot packs and postero-anterior central spinal manipulation. This program was applied three times per week; for six weeks. Results of this study revealed a significant decrease of local back pain intensity at the end of the treatment program. Results also showed a significant increase of both ROM of lower dorsal trunk flexion and cadence at the end of treatment program. Results presented a strong correlation between clinical and kinematic parameters. In conclusion, postero-anterior central spinal manipulation was an efficient and non risky maneuver in the treatment of dorsal disc prolapse with mild myelopathy. Both local and cord manifestations can be improved in these patients