Cases reported "Low Back Pain"

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11/17. Evaluation of Chapman's neurolymphatic reflexes via applied kinesiology: a case report of low back pain and congenital intestinal abnormality.

    OBJECTIVE: To describe the applied kinesiologic evaluation of Chapman's neurolymphatic (NL) reflexes in the management of a person with an unusual congenital bowel abnormality and its role in the manifestation of low back pain. The theoretical foundations of these reflexes will be elaborated on and practical applications discussed. CLINICAL FEATURES: A 29-year-old man had chronic low back pain. Radiographs of the patient's lumbar spine and pelvis were normal. Magnetic resonance imaging (MRI) demonstrated a mild protrusion of the fifth lumbar disk. Oral anti-inflammatory agents, cortisone injections, and chiropractic manipulative therapy provided little relief. Though generally in robust health, the patient was aware of a congenital intestinal abnormality diagnosed when he was a child; it was thought to be of no consequence with regard to his current back condition. INTERVENTION AND OUTCOME: The patient's history, combined with applied kinesiology examination, indicated a need to direct treatment to the large bowel. The essential diagnostic indicators were the analysis of the Chapman's neurolymphatic reflexes themselves, coupled with an evaluation of the traditional acupuncture meridians. The primary prescribed therapy was the stimulation of these reflexes by the patient at home. This intervention resulted in the resolution of the patient's musculoskeletal symptomatology, as well as improved bowel function. CONCLUSION: The rather remarkable outcome from the application of this relatively simple, yet valuable, diagnostic and therapeutic procedure represents a thought-provoking impetus for future study and clinical application.
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12/17. Unilateral septic arthritis of a lumbar facet joint secondary to acupuncture treatment--a case report.

    This report describes a case of septic arthritis of the lumbar facet joint probably as a result of acupuncture treatment. A 48 year old man with a long history of back pain presented with a two week history of increasing pain following a third session of acupuncture. Examination revealed tenderness in the right lumbosacral area and laboratory investigations revealed raised inflammatory markers with negative blood cultures. A bone scan and MRI scan showed evidence of septic arthritis of the right L5/S1 facet joint. An x ray computed tomography guided biopsy was carried out which isolated staphylococcus aureus. The patient was initially treated with intravenous antibiotics. A repeat MRI scan demonstrated persistent septic arthritis with adjacent early abscess formation. Surgical debridement of the facet joint was therefore performed. The patient had resolution of his symptoms and the inflammatory markers returned to normal. He regained a full range of movement of the lumbar spine. Very few cases have been reported of lumbar facet joint septic arthritis and this condition is rare in association with acupuncture treatment. A high index of suspicion needs to be maintained and if conservative management fails then debridement can result in an acceptable outcome.
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ranking = 7
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13/17. Post-lumbar puncture arachnoiditis. The need for directed questioning.

    The inflammation of the arachnoid mater may produce a fibrinous exudate around the roots that causes them to adhere to the dural sheath. We report the case of a man aged 23 years who suffered from acute inflammatory truncated sciatica. The diagnosis of adhesive arachnoiditis was made in front of clinical arguments associated to typical signs on Myelo CT Scan and MRI. The only explanation ever found was a traumatic lumbar puncture at the age of 6 years for suspected meningitis. Sequelae of arachnoiditis are difficult to diagnosis. When MRI or myelography suggests it as a possibility, precise directed questioning is necessary to seek a history, albeit distant, of spinal or meningeal events.
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ranking = 5
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14/17. electroacupuncture direct to spinal nerves as an alternative to selective spinal nerve block in patients with radicular sciatica--a cohort study.

    We applied electroacupuncture to the spinal nerve root by inserting needles under x ray imaging in three cases with radicular sciatica, as a non-pharmacological substitute for lumbar spinal nerve block. In all three cases, symptoms were markedly reduced immediately after electroacupuncture to the spinal nerve root. The sustained effect was noticeably longer than that of spinal nerve blocks previously performed, in two out of the three cases. We suggest that descending inhibitory control, inhibitory control at the spinal level, inhibition of potential activity by hyperpolarisation of nerve endings, or changes in nerve blood flow may be involved in the mechanism of the effect of electroacupuncture to the spinal nerve root. These results suggest that electroacupuncture to the spinal nerve root may be superior to lumbar spinal nerve block when it is applied appropriately in certain cases of radicular sciatica, taking into consideration patient age, severity of symptoms and duration of the disorder.
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ranking = 8
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15/17. Acupuncture complication--a case report.

    A migrating, broken acupuncture needle inserted 28 years prior, impinged the L5 nerve root causing severe chronic pain which was relieved by surgical removal. Worldwide literature revealed an unexpected and surprising number of serious complications from acupuncture treatment.
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ranking = 6
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16/17. 56 cases of disturbance in small articulations of the lumbar vertebrae treated by puncturing the effective points--a new system of acupuncture.

    In this series, the patients with disturbance of small articulations of the lumbar vertebrae were treated by puncturing the effective points and reduction by manual traction with satisfactory results, the cure rate being 39.3%, the markedly effective rate 28.6%, with a total effective rate 98.3%. This method is simple and easy to master, and highly effective. Therefore it is very acceptable to the patients. It is a very excellent therapeutic method for disturbance of small articulations of the lumbar vertebrae, sometimes complicated by acute lumbar sprain and chronic lumbar strain.
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ranking = 4
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17/17. Abducens palsy after an intrathecal glucocorticoid injection. Evidence for a role of intracranial hypotension.

    We report a case of abducens palsy eight days after an intrathecal glucocorticoid injection followed by post-lumbar puncture syndrome. T1-weighted magnetic resonance imaging scans showed marked diffuse postgadolinium enhancement of the supra- and infratentorial meninges consistent with intracranial hypotension syndrome. The palsy resolved almost completely and a repeat magnetic resonance imaging scan done after four months was normal. The mechanism of the meningeal thickening and contrast enhancement is discussed.
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ranking = 1
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