Management of a Chronic Lumbar Disk Herniation with Chiropractic Biophysics Methods After Failed Chiropractic Manipulative Intervention

Harrison extension lumbar traction. The patient is positioned in a form of 3-point bending. The weight of the upper torso is posterior, and the lumbar traction strap, while positioned just above the iliac crests, is pulling anterior, and a strap is placed around the femur head area to hold this area posterior. This allows the pelvis to flex forward when traction force is applied to the anterior strap. If the pelvis is already in forward flexion as a radiographic finding, then the pelvic strap is placed around the anterior superior iliac spines to eliminate pelvic flexion. If the sagittal balance of T12 is posterior to S1, then Harrison recommends a foam block be placed under the thoracic cage to translate this area anteriorly. The amount of tension in the anterior strap is varied to patient tolerance.

Initial and follow-up lateral lumbar radiographs. Pre-treatment (A) and follow-up (B) radiographs of a woman (23 yrs, 167.6 cm tall, 54.6 kg in weight) with initial hypolordosis in the lumbar spine. Lines are drawn on the posterior body margins as visual aids. In actual practice, these posterior vertebral body lines are extended and segmental angles are measured. The normal ellipse,¹⁹ drawn from posterior-superior S1 to the height of T12, is used as a guideline to compare with the posterior vertebral body margins. Note that 3-point bending traction has increased the ARA angle between L1 and L5 (deeper lordosis) and that the sagittal balance of T12 above S1 has improved on the follow-up radiograph (B). This subject had chronic lower back pain with an initial NRS of 5 of 10, first posttreatment NRS of 8 of 10, and follow-up NRS of 9 of 10 (10 = no symptoms, no restriction to daily living).