Reduction of thoraco-lumbar junctional kyphosis, posterior sagittal balance, and increase of lumbar lordosis and sacral inclination by Chiropractic BioPhysics® methods in an adolescent with back pain: a case report.

[Purpose] To present the structural improvement of an excessive junctional thoracolumbar kyphosis and related biomechanical parameters in an adolescent. [Participant and Methods] A 16 year old female presented with chronic back pains. Radiographic assessment revealed excessive posterior sagittal balance and thoracolumbar kyphosis and reduced lumbar lordosis and sacral inclination. Chiropractic BioPhysics® technique including mirror image®, anterior thoracic translation and thoracolumbar hyperextension traction was performed as well as spinal manipulation and postural exercises over an 8-week period. [Results] After 24 in-office treatments and a daily home program the patient reported a minimization of back pains and a better mood. Follow-up X-rays demonstrated a 48 mm reduction of posterior sagittal balance, a 22° reduction of thoracolumbar kyphosis, an 11° increase in lumbar lordosis, and a 10° increase in sacral inclination. [Conclusion] This is the first case documenting the non-surgical reduction of excessive thoracolumbar junctional kyphosis and related biomechanical parameters in an adolescent. Precise analysis of radiologic assessment for adolescents presenting with back pains is advised and are safe for the screening of postural disorders. There is a growing evidence base for the Chiropractic BioPhysics® technique approach in the correction of lumbar spine disorders; more research is encouraged to further evaluate this unique treatment.

Reduction of Scheuermann's deformity and scoliosis using ScoliBrace and a scoliosis specific rehabilitation program: a case report.

[Purpose] There is a paucity of high-quality data pertaining to the conservative management of adult spinal deformity, particularly Scheuermann's kyphosis. Long-term follow-up data for both treated and untreated Scheuermann's patients is also lacking. Given that changes in sagittal balance are associated with increased morbidity, and that these changes are increasingly prevalent in the spines of ageing populations, it is imperative that potential strategies aimed at reversing or minimizing this type of deformity are explored. As the number of elderly patients in developed countries increases, so does the need for a safe and effective non-surgical management option for patients with spinal deformity/sagittal imbalance. This case study details the influence of ScoliBrace rigid TSLO bracing in combination with a specific rehabilitation program in an adult patient with Kypho-scoliosis. [Participant and Methods] The authors describe a case involving the treatment of a 26-year-old male with Scheuermann's kyphosis and a lumbar scoliosis. The patient received 12 months of bracing with a supplemental exercise program. The patient was followed for a period of approximately 12 months. Patient progress was assessed using ODI, SRS-22r, NPRS, and radiographic Cobb angle measurements throughout treatment. [Results] The patient presented with an initial ODI score of 18/100, a SRS-22r score of 3.0, and an average NPRS score of 4/10. Initial Cobb angle measurements demonstrated a 79° thoracic kyphosis and a 30° (coronal plane) lumbar scoliosis. At the final assessment, the patient reported an ODI score of 6/100, an SRS-22r score of 3.91, and an average NPRS score of 0/10. The coronal plane Cobb angle measured 63°, and the thoracolumbar scoliosis had reduced to 25°. [Conclusion] The findings from this case study highlight that this type of brace in combination with exercise rehabilitation may be useful for reducing the magnitude of curves and reducing symptoms in patients presenting with adult kypho-scoliosis. Further investigation of this style of treatment is warranted in patients with sagittal plane imbalance.