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Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 18131
  Title Spinal manipulation postepidural injection for lumbar and cervical radiculopathy: a retrospective case series [case report]
URL http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Citation&list_uids=15389176
Journal J Manipulative Physiol Ther. 2004 Sep;27(7):449-456
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Peer Review Yes
Publication Type Case Report
Abstract/Notes OBJECTIVE: To describe the safety and potential therapeutic benefit of spinal manipulation postepidural injection in the nonsurgical treatment of patients with cervical and lumbar radiculopathy.

METHODS: The study design was a retrospective review of outcomes of 20 cervical and 60 lumbar radiculopathy patients who underwent spinal manipulation postepidural injection in a hospital setting. Patients received either fluoroscopically guided or computed tomography (CT)-guided epidural injection of a combination of lidocaine and Depo-Medrol. The manual therapy consisted of an immediate postepidural application of flexion distraction mobilization and then high-velocity, low-amplitude spinal manipulation to the affected spinal regions. Outcome criteria were empirically defined as significant improvement, temporary improvement, or no change. The minimum follow-up time for all patients was 1 year.

RESULTS: There were no complications associated with spinal manipulation, whereas 3 complications associated with the epidural injection procedure were noted. Of lumbar spine patients, 36.67% (n = 22) noted significant improvement, 41.67% (n = 25) experienced temporary improvement, and 21.67% (n = 13) reported no change. Of the patients undergoing spinal manipulation after cervical epidural injection, 50% (n = 10) noted significant improvement, 30% (n = 6) experienced temporary improvement, whereas 20% (n = 4) exhibited no change.

CONCLUSIONS: These data suggest that spinal manipulation postepidural injection is a safe nonsurgical procedure to use in the treatment of the patient with radiculopathy of spinal origin. This is also the first report of the use of spinal manipulation postepidural injection in the cervical spine.

Click on the above link for the PubMed record for this article; full text by subscription. This abstract is reproduced with the permission of the publisher.

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