Clinical Features: A 16-year-old high school football player with a history of chronic low back pain and multiple traumas sought care for his chronic low back pain. Radiographic examination showed a non-union at S1, and MRI examination showed a disc herniation at L5-S1. Diagnosis was lumbar disc herniation with spina bifida occulta and knife-clasp syndrome.
Intervention and Outcome: The patient was managed with chiropractic care over a period of 24 weeks. Flexion-distraction manipulation was utilized, along with physical therapy modalities and core-strengthening exercises. On re-evaluation his condition was significantly improved. Because of this diagnosis, he and his parents questioned the safety of sports participation and whether or not he would qualify for a military career; we therefore explored sports participation and career advice.
Conclusion: This case describes chiropractic management of an adolescent with a constellation of conditions not usually seen in this age group. Information is provided on how to advise patients about the possibility of serious injury during sports participation as well as potential military career choices based on this diagnosis.
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