title: Utilization of mechanical diagnosis and therapy (MDT) for the treatment of lumbar pain in the presence of known lumbar transverse process fractures: a case study.
abstract: BACKGROUND
  Spinal fractures are typically considered a contraindication to mechanical diagnosis and therapy (MDT).
  
  
  OBJECTIVE
  The purpose of this case study is to illustrate how MDT was used safely and effectively to treat lumbar pain in a patient with multiple lumbar transverse process fractures.
  
  
  METHODS
  The subject was a 24-year-old female with left L2-5 transverse process fractures, sustained 10 weeks prior in a pedestrian versus motor vehicle accident.
  
  
  METHODS
  After collaboration with her physiatrist, an MDT examination revealed a presentation consistent with the lumbar derangement syndrome.
  
  
  CONCLUSIONS
  After three visits, utilizing patient generated forces with the extension principle of treatment, her pain, Oswestry disability index (ODI) score, and function all improved.
authors: Community Spine Center, Community Health Network, Indianapolis, IN, USA.
authors: J L
authors: JL
authors: Elenburg
authors: Community Spine Center, Community Health Network, Indianapolis, IN, USA.
authors: B S
authors: BS
authors: Foley
authors: Community Spine Center, Community Health Network, Indianapolis, IN, USA.
authors: K
authors: K
authors: Roberts
authors: Community Spine Center, Community Health Network, Indianapolis, IN, USA; Department of Physical Therapy, Indiana University, IUPUI, Indianapolis, IN, USA.
authors: A J
authors: AJ
authors: Bayliss
keywords: Classification; Derangement; Directional preference; Fracture; Low back pain; McKenzie method; Mechanical diagnosis and therapy; Red flags