Integrative Manual Therapy Treatment of Undersized Vertebrae: A Case Study

Author: William Wheeler, MA, IMP

Abstract: This article describes the treatment of 37-year-old women. She received a medical diagnosis of both C5 and C6 as being congenitally small, and degenerative changes were also recognized at the C4/C7 area. The article describes manual therapy treatment of the spine, and the subsequent significant change in Range of Movement. This article also discusses the need to use manual therapy techniques in similar cases.

Key Words: Cervical, Neck, spine

Introduction

One of the ultimate aims when using Integrative Manual Therapy© (IMT) is to increase the daily functioning of a patient. When focusing on a spinal lesion, the practitioner using IMT achieves this by introducing more integrity to the vertebrae, and related tissues, e.g., vascular, disk, spinal cord, and nerve roots. The vertebrae are able to increase their stability and biomechanical functioning; there is more vertebral movement on all three planes, saggittal, coronal, and transverse. Other results can also occur with patients, such as decreases in pain.

Specific research about abnormally small vertebrae was not found in a MEDLINE search. However, there are numerous studies about the morphology of vertebrae. Rheumatoid arthritis and spinal disease’s erosive effects on the spine structure is explored in Sims-Williams H, Jayson MI, Baddeley H. (1977). Gilad I, Nissan M., (1985) delineates the proportions of the vertebrae throughout the spine using radiographic measurements. Cvijetic, S, McCloskey E, Korsic, M., (2000) elaborate upon the relationships between vertebral osteophytosis and vertebral deformities. Kim, FM (2000) explores the risks of instability from developmental anomalies of the craniocervical junction and cervical spine

Patient History

The patient was a 37-year-old woman. She described experiencing pain in the neck, and both upper extremities. Her left shoulder pain in particular was aggravated by activity. The patient reported having a history of low back pain, and had undergone a L3/L4 fusion.

A July 2000 medical report provided a diagnosis of both C5 and C6 segments as congenitally small, and degenerative changes were also observed in the C4 through C7 area. No major disc herniations were reported, however, mild disc bulging was reported in both the C4/C5, and C6/C7 discs. She was refused any surgical options at C5/C6 area, because the doctors believed it to be too risky. The patient’s MRI image, labeled #1, was part of a series that contributed to the report and diagnoses.

Treatment

The patient received the following treatment: Compression Syndromes of each vertebra, C4 and C5. Compression Syndromes of the following disks: C4/C5, C5/C6, and C6/C7. Immune Deficiency Motility was performed throughout the cervicals. Two additional techniques were also performed, one for scar tissue, and one addressing spinal compression.

The photos illustrate the range of motion (ROM) changes. Thoracic ROM in flexion increased from 15° to 40°. Not illustrated with photos were other ROM changes. Cervical rotation to the right increased from 10° to 40°, while left rotation increased from 0° to 5°. The patient also reported a decrease of pain.

Conclusion

Treatment of vertebrae with Integrative Manual Therapy© provides a new medical option for patients experiencing lesions viewed as risky surgical intervention. Integrative Manual Therapy© leads to increases in range of motion, and as a result, increased quality of functioning.

Bibliography

Gilad, I, Nissan M., (1985). "Sagittal radiographic measurements of the cervical and lumbar vertebrae in normal adults." Br J Radiol. Nov; 58(695): 1031-4.

Cvijetic, S, McCloskey E, Korsic, M., (2000). "Vertebral osteophytosis and vertebral deformities in an elderly population sample." Wien Klin Wochenschr.

Kim, FM., (2000). "Developmental anomalies of the craniocervical junction and cervical spine." Magn Reson Imaging Clin N Am. Aug;8(3): 651-74.

Williams H, Jayson, M.I, Baddeley H., (1977). "Rheumatoid involvement of the lumbar spine." Ann Rheum Dis. Dec; 36(6): 524-31.

 

Figures

Figure 1. - MRI-#1

 

Figure 2. - Pre-Treatment ROM

 

Figure 3. - Post-Treatment ROM