Manual correction of an acute lumbar lateral shift: maintenance of correction and rehabilitation: a case report with video.
The acute onset lumbar lateral shift, otherwise known as a list or acute scoliosis, is a common clinical observation associated with low back pain. In general orthopaedics, the presence of a lateral shift is associated with a poor prognosis; however, a manual correction method devised by McKenzie is claimed to produce rapid reversal of the deformity and reduction in pain. This single-case report presents the details of the McKenzie Mechanical Diagnosis and Treatment (MDT) management of a major right-sided lateral shift, which includes the manual correction technique, self-correction and management, prophylaxis, pain ablation, and rehabilitation to a high level of athletic function, with long-term follow-up at 9 months. The lateral shift is widely accepted as being associated with disc pathology, but the exact mechanism of shift production remains speculative. hypotheses include muscle spasm, avoidance of irritation of a spinal nerve, and space-occupying or space-deficient disc mechanics. The hypotheses used to explain the lateral shift phenomena are discussed. (Case report is supplemented by video stream, available at jmmtonline.com/).
Laslett
Mark
M
Director of Clinical Services, PhysioSouth Ltd, Christchurch, Canterbury, New Zealand.