Case Studies Updated

Transcription

1 S O L U T I O N S Case Studies Updated

2 Hill DT Solutions Cervical Decompression Case Study An 18-year-old male involved in a motor vehicle accident in which his SUV was totaled suffering from significant neck pain, headaches, and bilateral parathesia. The above captioned patient complained of neck pain, headaches, and numbness and tingling in his arms and hands. Upon examination, he had a positive cervical compression test, restricted ROM in the cervical spine with significant trigger point pain identified at multiple sites in the cervical and upper thoracic spine. Cervical x-rays were ordered and revealed a reversal of the normal cervical lordosis, paradoxical motion at the posterior motor units of C1, C3, C5, C6 and C7 in flexion and at C1, C3, C5 and C6 in extension. Cervical subluxation was confirmed through a correlation of motion palpation, x-ray and computer assisted motion analysis utilizing an adjusting instrument. Pain indices were noted at an 8-9 out of 10 for neck pain and a 5-6 out of 10 for headaches. The bilateral numbness was noted as intermittent and mild to slight. The patient was recommended a 6-8 week treatment plan of chiropractic adjustment or CMT, exercise therapy or muscle rehab, and 8-10 visits of non-surgical axial spinal decompression using the Hill DT Decompression Table. All of his symptoms abated within 4-6 weeks. Due to the significant level of improvement, a follow-up lateral cervical film was ordered to determine if a cervical posture pump or similar device should be recommended as ongoing support for postural improvement of the loss of the cervical curve. Upon re-evaluation it was noted however, that the patient had fully recovered from his symptoms. His ROM was normal, he had no positive orthopedic or neurological signs, and on x-ray his cervical spine had returned to the normal lordosis. Pre and post cervical films confirm the patient s structural correction. Summary The Hill DT Decompression table played a significant role in the patient s treatment plan. It is my opinion that using a dual treatment program at each decompression visit of protocol 2 for 15 minutes at 12 pounds and protocol 3 for 7 minutes at 10 pounds was key to the patient s recovery. Case study authored by Dr. Timothy Burkhart, D.C.

3 Pre-Treatment Post-Treatment

4 HillDT Solutions Lumbar Decompression Case Study A 42-year old male tri-athlete complains of low back and bilateral hip pain. The pain was getting worse over the past month especially after exercising. Upon examination, acute point tenderness was found over L5, S1, and the right sacroiliac joint. There were myospasms over the right paralumbar region. Orthopedic tests revealed a positive Kemp s test and Ely s sign. Valsalva s and straight leg raise test were negative. There was a positive Derefield test on the right. Restricted range of motion in the lumbar, sacrum, and pelvis was found. It was determined on motion palpation that there was subluxation of the lumbar, sacrum, and bilateral hip regions. Lumbopelvic x-rays were taken and revealed a grade #1 spondylolisthesis that was verging on a grade #2, L5- S1 disc degeneration, sacrum apex posterior, lumbar rotation and double posterior-inferior iliums. Pain levels were noted at 7 out of 10 for low back pain and 5 out of 10 for bilateral hip pain. The patient was recommended a 6-8 week treatment plan of chiropractic adjustments or CMT, exercise therapy or neuromuscular rehabilitation, and 20 non-surgical axial decompression treatments or SDC using the Hill DT Decompression Table. The Thompson drop technique was utilized for CMT as well as a variable frequency computerized adjusting Instrument. Pierce L5 supine drop for spondylolisthesis was performed as well. Due to the instability of a spondylolisthesis, protocol 3 on the Hill DT table was utilized with 50 pounds of pressure for 18 minutes, a targeting angle set at 10 degrees, and lumbar capture at 1. There was also a 10 pound medicine ball placed over the stomach. Protocol 3 is very similar to traditional mechanical traction but it slowly ramps up in 20 percent increments before reaching its targeted pressure, then holds that pressure consistently until the end of the treatment, then ramps down in 20 percent increments. Protocol 3 was used for the initial 10 SDC treatments along with continued chiropractic care, infrared light therapy, electric stimulation, and core exercises. The patient s pain level at best was still 5 out of 10, but there was increase in range of motion. On SDC visit number eleven, treatments were changed to Protocol 2, which is a true decompression program with less aggressive force than Protocol 1. This protocol ramps up to the high force in 20 percent increments until reaching the maximum pressure. It then pumps back and forth between 50 percent and 100 percent with 30 second holds at both forces, then ramps down to 0. The patient tolerated the program well, and on subsequent visits we slowly increased the poundage, eventually reaching 60 pounds of pressure but still utilizing all the other original parameters. Upon completion of the 20th SDC visit, there was still mild tenderness over the L5 spinous process region but both Kemp s and Ely s tests were negative. The patient s low back and bilateral hip pain were both none to minimal ranging from 0 to 2 on a 10 scale, and he was not experiencing increased pain after exercising. Due to the significant improvement, a lateral lumbar film was ordered to determine if physical changes had occurred on film and to help on further recommendations. The X-ray revealed an increase in the L5-S1 disc space along with a decrease in the L5 anterior slippage from the spondylolisthesis. The patient was then recommended to continue a maintenance decompression program, CMT, and core exercise program due to the chronic nature of a spondylolisthesis condition. The SDC and CMT were recommended as follows: 1 SDC/CMT in 2 weeks then 1 SDC/CMT at 4 week intervals with a re-evaluation after 6 total visits. This patient has continued to do well. Summary I feel the Hill DT Decompression Table was a significant part of the patient s success as their results would not have been accomplished with traditional adjustments and adjunct therapies. Case study authored by Dr. James Chapp, D.C.

5 Pre-Treatment Post-Treatment (20 Treatments)

6 Hill DT Solutions Cervical Decompression Case Study Cervical Disc Herniation for 3 years in 50 year old. A 50 year old female presented in my office with the chief complaints of: neck pain, dizziness, headache and painful arms, which have been worsening. Her past treatments have included medication and physiotherapy. The significant examination findings before and after treatment were as follows. Before Treatment Her pain scale was 6 of 10 and her Oswestry Index Questionnaire score was 24 of 50. All cervical ROM were within normal limits except extension with significant bilateral trigger point pain in the cervical spine. She had a positive cervical distraction test and positive Triad of Dejerene test. Reflex testing included: triceps (rt) grade 2, triceps (lt) grade 1, biceps (b) grade 1 and brachioradialis (b) grade 1. Sensory (2 point discrimination): C7 (lt) decreased, T1 (rt) decreased, T2 (rt) decreased. Motor strength was within normal limits. She presented with an MRI which revealed: C6-7 broad based disc protrusion, mild central canal stenosis and dorsal osteophyte formation. A full series of cervical x-rays were taken which revealed: decreased disc space at C6-7, C6 posterior inferior osteophyte and C7 posterior superior osteophye formation. After Treatment Oswestry Index Questionnaire score was 7 of 50, Reflex: All reflexes grade 2. Sensory: within normal limits. Motor: All within normal limits. Cervical ROM: All within normal limits. Treatment: An 8 week treatment protocol included: heat (10 minutes minimum), axial non-surgical spinal decompression using the Hill DT Decompression table, ice (10 minutes minimum), chiropractic adjustments or CMT (as needed), nutritional supplements, and home exercises. Spinal decompression protocol varied from 10 to 15 minutes, using programs 2 and 1, at a 6 degree angle (which created the best results) and weight of 8 to 10 lbs. Her symptoms continued with minimal changes until the 10th treatment when her pain dropped instantaneously to 0 of 10 with decreasing stiffness thereafter. Summary This patient was discharged with stretches and exercise to be done daily and strict adherence to limited lifting above the shoulders for the next year. Increasing weight without developing pain was encouraged. Spinal decompression maintenance treatment is recommended if needed. Her progress, although limited during the first half of the treatment, significantly improved in the later half, indicating the complexity of the condition. At discharge, this patient was experiencing no pain and had resumed most of her activities of daily living with the intent of resuming all activities within a few years as strength increases. Her outcome was increased as a result of the Hill DT Spinal Decompression table, the treatment plan and the patient s dedication and strict adherence to the protocol guidelines. Case study authored by Dr. Donald Geisler, D.C

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8 Hill DT Solutions is a results based company...by chiropractors for chiropractors. Lead by our team of MasterMind chiropractors with years of experience teaching, diagnosing & treating patients in their respective practices, Hill DT owners have a unique opportunity to be at the forefront of spinal decompression treatment profiting from our experts and quickly becoming proficient with spinal decompression treatment. Hill DT Solutions is highly qualified and uniquely positioned to offer a comprehensive package of sales, service and training in spinal decompression therapy to complement the unique advantages of the Hill DT Table. Hill DT Solutions is the sole authorized partner to advertise, sell and train for the Hill DT Table. For more information and support, please contact HillDT Solutions at Jeff VanderWal Vice President Sales & Marketing Hill DT Solutions LLC 7105 Broadmoor Ave. Caledonia, MI p: e: info@hilldtsolutions.com S O L U T I O N S Disclaimer: The information expressed in this document are those of the specific Authors. Images and graphics have not been altered or enhanced to support these views in any way.