Conservative Treatment of a Patient With Previously Unresponsive Whiplash-Associated Disorders Using Clinical Biomechanics of Posture Rehabilitation Methods

A, The initial MRI of the lateral cervical spine (10/18/00). Abnormal marrow signal with slight loss of vertebral body height at C5, possibly a very mild compression deformity. Small central disk protrusion at C4-5 and small disk bulge at C5-6. No central canal stenosis or significant neural foraminal narrowing identified. B, The initial lateral cervical view dated 9-15-2000 taken at the previous provider's clinic.

A, The initial neutral lateral cervical posture showing the patient's severe head protrusion. B, The initial lateral cervical obtained at the CBP provider's clinic dated 3/12/2001. Notice the lack of spinal correction after numerous multiple modalities. The broken black line represents the path of the posterior longitudinal ligament (George's line), whereas the solid black line represents normal spinal position described by Harrison et al.²²

A, The patient is receiving a Harrison CBP posterior skull translation coupled with extension adjustment. B, The patient is using the Harrison CBP mirror-image exercise of skull posterior translation coupled with extension. C, Extension-compression traction²¹ was used for reduction of abnormal head protrusion and cervical curve correction.

A, A significant improvement in the patient's 10-week follow-up of lateral cervical posture. B, The lateral cervical radiograph is shown and evidences marked improvement toward normal. This is for a total of 40 in-office rehabilitation visits.

Because of an improvement in his lateral cervical configuration, the patient was switched to a modified type of two-way cervical extension-compression traction²³ so as to further stress bending toward a normal lordosis.

A, The patient's 18-week follow-up lateral posture. B, The lateral cervical radiograph. This is for a total of 24 additional visits on the modified two-way extension-compression traction.

Magnetic resonance imaging c-spine dated 10/06/01. Mild concentric disk bulging at C4/5 and C5/6 is associated with disc height diminution and desiccation. No evidence of a disc herniation at any level. Mild bilateral foraminal stenosis at C4/5 and C5/6, right greater than the left, is secondary to uncovertebral spurring.