title: Lumbar lateral shift in a patient with interspinous device implantation: a case report.
abstract: BACKGROUND
  Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation.
  
  
  METHODS
  A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS. Her chief complaints included sitting for long periods, vacuuming and ascending stairs into her home.
  
  
  RESULTS
  The patient was treated during eight visits over 30 days. Treatment interventions included manual shift correction, self-correction and management, joint mobilisation below the level of IPD implantation ,neurophysiology education, and development of a home exercise programme. At discharge, her leg pain was resolved and all goals had been met. The patient reported maintenance of gains at 6-month follow-up.
  
  
  CONCLUSIONS
  Utilisation of the MDT approach, including LLS correction, produced positive outcomes in a complex patient with previous IPD implantation. Future research should investigate treatment and outcomes after invasive spinal procedures in similar patient populations to better inform clinical management.
  
  
  METHODS
  4.
authors: ProActive Physical Therapy, Tucson, AZ, USA.
authors: Seth
authors: S
authors: Peterson
authors: Arizona School of Health Sciences, A. T. Still University, Mesa, AZ, USA.
authors: Cheri
authors: C
authors: Hodges
keywords: Interspinous process device; Lateral shift; Lumbar surgery; McKenzie method; Mechanical diagnosis and therapy; X-Stop