title: Improvement in chronic low back pain in an aviation crash survivor with adjacent segment disease following flexion distraction therapy: a case study.
abstract: OBJECTIVE
  The purpose of this case study is to describe the chiropractic management of chronic low back pain in a patient with adjacent segment disease.
  
  
  METHODS
  The patient was a 30-year-old man with a 3-year history of chronic nonspecific low back pain following a lumbar disk herniation. Two years before this incident, he had severe lumbar fractures and cauda equina injury due to an aviation accident that required multilevel lumbar fusion surgery, vertebrectomy, and cage reconstruction.
  
  
  RESULTS
  The patient received chiropractic management using Cox Flexion Distraction over a 4-week period. A complete reduction of symptoms to 0/10 on a verbal numerical rating scale was achieved within 4 weeks. At 3 months, the patient was able to work 8 to 9 hours per day in his dental practice with no pain. At 9 months, the patient continued to report a complete reduction of symptoms.
  
  
  CONCLUSIONS
  This report describes the successful management of a patient with chronic low back pain associated with adjacent segment disease using Cox Flexion Distraction protocols.
authors.affiliation: Chiropractor, Private Practice, Vancouver, BC, Canada.
authors.forename: Dean M
authors.initials: DM
authors.lastname: Greenwood
keywords: Back pain; Complementary therapies; Failed back surgery syndrome; Manipulation, chiropractic; Spinal fusion