Donald R. Murphy, DC, DACAN, Eric L. Hurwitz, DC, PhD, Rick H. Morris, DC, CCSP
The purpose of this study is to present an additional series of cases in which patients with the finding of spinal cord encroachment on MRI were treated with an approach that includes non-surgical specific joint mobilization with specific, supportive therapies. This study will report the outcomes and complications, if any, of this treatment. This is the first of two studies performed at this office. Due to a deadline for presentation at the 2013 ACC/RAC Research Conference, this one uses patients currently being treated for this condition and is therefore smaller. The second will contain those that have been treated over the last five years and should be about three to four times larger.
Patients with spinal cord compression often have severe neck, upper back, arm, shoulder and/or head pain, numbness and weakness; although, some may be without symptoms. Other symptoms may include spasticity, discoordination, loss of balance, head and face symptoms, and may even effect hearing and vision.
Typical treatment often includes surgical fusion and carries with it the possibility of severe complications and almost certain accelerated degeneration of the cervical spine. Therefore, a non-surgical approach that is safe and effective should be pursued.
The Study Design:
-
19 patients with MRI evidence of spinal cord compression seen between 6-9-11 and 8-12-12 (all patients meeting criteria were included).
-
All patients had spinal cord compression as a result of disc herniation, osteophyte formation, hypertrophied ligamentum flavum or combination of these.
-
Two treatment facilities were used (The Morris Spinal Stenosis and Disc Center and The Rhode Island Spine Center)
The Typical Patient Included In This Study:
-
Mean age: 52 years
-
Mean duration of symptoms: 3.4 years
-
2 patients showed myelomalacia (spinal cord damage/degeneration) on MRI
-
4 patients had examination findings of myelopathy (spinal cord damage)
The Results of Treatment:
-
The mean % improvement in disability (BDQ): 40.5%
-
The % of patients with clihnically meaningful improvement in disability (NDI): 88%
-
The mean % change in VAS (visual pain scale): 50%
-
0 patients had adverse reactions or complications to treatment
-
1 patient had transient increase in pain and paresthesia that resolved in two weeks with continued treatment
Conclusions
Patients suffering from encroachment on the cervical spinal cord from degenerative changes of the cervical spine can be safely and effectively treated without surgery using a precise method of cervical mobilization/manipulation, physical therapies, rehabilitation and allied physical modalities designed specifically for this condition. This is especially meaningful since these patients had meaningful decrease in pain and disability while reducing or eliminating their pain medications. This may give patients another treatment option without the risks of surgery. This study coincides with others and warrants further larger studies to see if it can be reproduced by other facilities.
The Morris Spinal Stenosis and Disc Center has worked hard to become the leading office in the country specializing in the non-surgical treatments of Severe Spinal Stenosis, Disc Disease/Degeneration/Herniation and Spinal Cord Compression.
If you know of someone with these conditions and would not mind being part of our research studies, we encourage you to refer them to our office (call 310-451-5851). We are continuing the study for several years.