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Case Study of Postsurgical Cauda Equina Syndrome and Chiropractic

From the Journal of Manipulative and Physiological Therapeutics (JMPT) comes a case study of a 35-year-old woman with cauda equina syndrome helped by chiropractic care. The case study was published in the November-December 2004 Issue of the peer-reviewed research periodical.

In this evidence-based case report, the woman presented with complaints of midback pain, low-back pain, buttock pain, saddle anesthesia, and bladder and bowel incontinence, for a period of 6 months. She had undergone emergency surgery for acute cauda equina syndrome due to lumbar disc herniation, six months earlier. The cauda equina (CE) is formed by nerve roots at the end of the spinal cord inside the spinal column. Cauda equina syndrome (CES) is when there is low back pain, unilateral or usually bilateral sciatica, sensory disturbances, bladder and bowel dysfunction, and variable lower extremity motor and sensory loss.

The patient eventually began chiropractic care and received a series of adjustments. After only 4 adjustments, the patient reported full resolution of midback, low back, and buttock pain. After an additional 4 visits the patient had not yet seen improvement in her neurologic symptoms. However, even though this patient had received surgery, there were no adverse effects noted. This case study did not look at possible results beyond the initial 8 visits. The study noted that a review of previous studies showed that 2.3% to 12% of chiropractic patients have a history of at least one prior spinal surgery.

The conclusion of the published case study noted that this case appeared to be the first published case of chiropractic adjustments being used for a patient suffering from chronic cauda equina syndrome. It seems that this type of spinal adjustment was safe and effective for reducing back pain and had no effect on neurologic deficits in this case. They noted that rapid pain relief seen in this case is extremely unusual for patients with cauda equina syndrome. They therefore concluded that it was very likely that the adjustments contributed to the resolution of spinal pain in this patient