Case Report
Volume 12 Issue 8 - 2021
Re-Stabilization of an Unstable Lumbosacral Segment in a Patient with Chronic back Pain: A Case Report
Alan Breen1*, Clive Maynard2 and Ravi Ayer3
1Centre for Biomechanics Research, AECC University College, Parkwood Campus, Bournemouth, Dorset, UK
2Private Practice, New Forest Clinics, Lymington, Hants, UK
3Radiology Department, Poole General Hospital NHS Foundation Trust, Longfleet Rd, Poole, UK
*Corresponding Author: Alan Breen, Centre for Biomechanics Research, AECC University College, Parkwood Campus, Bournemouth, Dorset, UK.
Received: June 28, 2021; Published: July 30, 2021


Background: Spinal instability is poorly understood. This case report describes the re-stabilization of an unstable vertebral motion segment in a patient with chronic low back pain.

Case Presentation: A 50-year-old male presented at his local rheumatology service with chronic lumbo-pelvic pain. MRI revealed mid-lumbar disc degeneration with Modic 1 change at L3-4. An epidural steroid injection was given, followed by antibiotic therapy, but with no effect. A quantitative fluoroscopy (QF) assessment revealed instability at L5-S1 with hypomobility at the degenerate mid-lumbar levels. He received manipulation therapy to the mid-lumbar spine, plus activity modification to minimize lumbo-sacral stresses. This gave 70% improvement which was sustained over 5 years. Follow-up QF and MRI revealed reduction in lumbo-sacral instability, but no change in the L3-4-disc signal.

Conclusion: This case report is the first to demonstrate restabilisation of an unstable vertebral motion segment.

Keywords: Lumbar Spine; Instability; Quantitative Fluoroscopy; Upright MRI


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Citation: Alan Breen., et al. “Re-Stabilization of an Unstable Lumbosacral Segment in a Patient with Chronic back Pain: A Case Report”. EC Orthopaedics 12.8 (2021): 94-101.

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