Improvements in Cervical Spinal Canal Diameter and Neck Disability Following Correction of Cervical Lordosis and Cervical Spondylolistheses Using Chiropractic BioPhysics Technique: A Case Series

Abstract

Cervical spondylolisthesis indicates instability of the spine and can lead to pain, radiculopathy, myelopathy and vertebral artery stenosis. Currently degenerative cervical spondylolisthesis is a wait-and-watch condition with no treatment guidelines. A literature review and discussion will be provided. 8 females presented with neck pain, disability, and history of motor vehicle collision. Radiographs revealed abnormal cervical alignment, spinal canal narrowing, and spondylolistheses. After 30 sessions of Chiropractic BioPhysics® care over 12 weeks, patients reported improved symptoms and disabilities. Radiographs revealed improvements in cervical alignment, spondylolistheses, and spinal canal diameter. Motor vehicle collision may cause instability and abnormal alignment of the cervical spine leading to cervical spondylolisthesis. Improving spinal alignment may be an effective treatment to reduce vertebral subluxation and cervical spondylolistheses and improve neck disability as a result of improved spinal alignment.

Keywords: CBP; Chiropractic BioPhysics; adjustment; cervical spine; cervical spondylolisthesis; chiropractic; posture; spinal instability.

Figure 1

63-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 1a Patient 1 Pre-Treatment NLC Radiograph 1a Findings: NLC image shows Tz C2–C7 of 17.4 mm, ARA C2–C7 of −50.6°, spondylolistheses at C2–C3, C3–C4, and C5–C6 with Tz measurements of −3.5 mm, −2.7 mm, and 2.6 mm, respectively. Tz SCD at C2–C3, C3–C4, and C5–C6 measure 15, 14, and 16 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 1b Patient 1 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 1b Findings: NLC image shows Tz C2–C7 of 5.2 mm, ARA C2–C7 of −46.0°, Tz C2–C3, Tz C3–C4, and Tz C5–C6 measurements of −0.9 mm, −0.3 mm, and 0.4 mm, respectively. Tz SCD at C2–C3, C3–C4, and C5–C6 measure 18, 16, and 17 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 2

67-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 2a Patient 2 Pre-Treatment NLC Radiograph 2a Findings: NLC image shows Tz C2–C7 of 8.7 mm, ARA C2–C7 of −3.5°, spondylolistheses at C3–C4 and C4–C5 with Tz measurements of 2.5 mm, and 4.4 mm, respectively. Tz SCD at C3–C4 and C4–C5 measure 14 mm and 15 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 2b Patient 2 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 2b Findings: NLC image shows Tz C2–C7 of 7.8 mm, ARA C2–C7 of −19.3°, Tz C3–C4 and Tz C4–C5 measurements of 0.1 mm, and 1.1 mm, respectively. Tz SCD at C3–C4 and C4–C5 measure 16 mm and 17 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 3

53-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 3a Patient 3 Pre-Treatment NLC Radiograph 3a Findings: NLC image shows Tz C2–C7 of 2.6 mm, ARA C2–C7 of −6.1°, spondylolistheses at C3–C4, C5–C6, and C6–C7 with Tz measurements of −2.1 mm, −4.3 mm, and −2.0 mm, respectively. Tz SCD at C3–C4, C5–C6, and C6–C7 measure 15 mm, 15 mm, and 15 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 3b Patient 3 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 3b Findings: NLC image shows Tz C2–C7 of 10.7 mm, ARA C2–C7 of −16.8°, Tz C3–C4, Tz C5–C6, and Tz C6–C7 measurements of −0.5 mm, −0.6 mm, and −0.5 mm, respectively. Tz SCD at C3–C4, C5–C6, and C6–C7 measure 17 mm, 18 mm, and 16 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 4

46-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 4a Patient 4 Pre-Treatment NLC Radiograph 4a Findings: NLC image shows anterior surgical fusion of C4–C6, Tz C2–C7 of 1.5 mm, ARA C2–C7 of −12.4°, spondylolisthesis at C2–C3 with a Tz measurement of −4.5 mm. Tz SCD at C2–C3 measures 15 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 4b Patient 4 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 4b Findings: NLC image shows anterior surgical fusion at C4–C6, Tz C2–C7 of 7.4 mm, ARA C2–C7 of −19.1°, Tz C2–C3 measurement of −0.8 mm. Tz SCD at C2–C3 measures 18 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 5

51-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 5a Patient 5 Pre-Treatment NLC Radiograph 5a Findings: NLC image shows Tz C2–C7 of 27.3 mm, ARA C2–C7 of 2.4°, spondylolistheses at C2–C3, C3–C4, C4–C5, and C5–C6 with Tz measurements of −3.0 mm, 3.1 mm, 4.2 mm, and −4.1 mm, respectively. Tz SCD at C2–C3, C3–C4, C4–C5, and C5–C6 measure 15 mm, 15 mm, 15 mm, and 13 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 5b Patient 5 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 5b Findings: NLC image shows Tz C2–C7 of 21.9 mm, ARA C2–C7 of −4.4°, Tz C2–C3, Tz C3–C4, Tz C4–C5, and Tz C5–C6 measurements of −1.7 mm, 0.0 mm, 0.4 mm, and −0.2 mm, respectively. Tz SCD at C2–C3, C3–C4, C4–C5, and C5–C6 measure 18 mm, 17 mm, 17 mm, and 16 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 6

58-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 6a Patient 6 Pre-Treatment NLC Radiograph 6a Findings: NLC image shows Tz C2–C7 of 23.4 mm, ARA C2–C7 of −11.7°, spondylolistheses at C2–C3 and C3–C4 with Tz measurements of −2.7 mm and −2.0 mm, respectively. Tz SCD at C2–C3 and C3–C4 measure 14 mm and 15 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 6b Patient 6 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 6b Findings: NLC image shows Tz C2–C7 of 23.8 mm, ARA C2–C7 of −11.8°, Tz C2–C3 and Tz C3–C4 measurements of 0.2 mm and −0.7 mm, respectively. Tz SCD at C2–C3 and C3–C4 measure 16 mm and 17 mm, respectively. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 7

36-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 7a Patient 7 Pre-Treatment NLC Radiograph 7a Findings: NLC image shows Tz C2–C7 of 24.3 mm, ARA C2–C7 of −12.7°, spondylolisthesis at C2–C3 with a Tz measurement of −2.2 mm. Tz SCD at C2–C3 measures 15 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 7b Patient 7 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 7b Findings: NLC image shows Tz C2–C7 of 19.1 mm, ARA C2–C7 of −17.1°, Tz C2–C3 with a measurement of −0.5 mm. Tz SCD at C2–C3 measures 17 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.

Figure 8

53-year-old female with NP, bilateral upper trapezii pain, neck stiffness, restricted cervical ROM, cervical radicular symptoms, and a history of motor vehicle collision trauma. Image Features: The green line represents a normal, ideal cervical alignment. The red line represents the actual posterior tangent lines of the C2–C7 vertebrae. The yellow line and text represent the spinal canal diameters and measurements at spondylolisthesis locations. Figure 8a Patient 8 Pre-Treatment NLC Radiograph 8a Findings: NLC image shows Tz C2–C7 of 15.5 mm, ARA C2–C7 of −29.3°, spondylolisthesis at C2–C3 with a Tz measurement of −3.1 mm. Tz SCD at C2–C3 measures 15 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4. Figure 8b Patient 8 Post-Treatment NLC Radiograph Intervention: Chiropractic BioPhysics® Mirror Image® spinal adjustments, exercises, and traction. 8b Findings: NLC image shows Tz C2–C7 of −1.8 mm, ARA C2–C7 of −42.0°, Tz C2–C3 with a measurement of −0.3 mm. Tz SCD at C2–C3 measures 18 mm. Technique: 30 mAs, 200 mA, 76 kVp, 72″ FFD, CR at C4.