Journal of Manipulative and Physiological Therapeutics
Volume 30, Issue 3 , Pages 234-238 , March 2007

Twenty-Year-Old Pathogenic “Active” Postsurgical Scar: A Case Study of a Patient With Persistent Right Lower Quadrant Pain

  • Alena Kobesova, MD

      Affiliations

    • Second Medical Faculty, Rehabilitation Clinic, University Hospital Motol, Charles University, Prague, Czech Republic
    • Corresponding Author InformationSubmit requests for reprints to: Alena Kobesova, MD, Department of Rehabilitation, University Hospital Motol, V Uvalu 84, 15006 Prague 5, Motol, Czech Republic.
  • ,
  • Craig E. Morris, DC

      Affiliations

    • Professor of Clinical Sciences, Cleveland Chiropractic College, Los Angeles, Calif
    • Director, FIRST Health Clinic, Torrance, Calif
  • ,
  • Karel Lewit, MD, DSc

      Affiliations

    • Second Medical Faculty, Rehabilitation Clinic, University Hospital Motol, Charles University, Prague, Czech Republic
  • ,
  • Marcela Safarova, PT

      Affiliations

    • Second Medical Faculty, Rehabilitation Clinic, University Hospital Motol, Charles University, Prague, Czech Republic

Received 19 February 2006 ,Revised 14 May 2006 ,Accepted 1 June 2006.

References 

  1. Lewit K, Olsanska S. Clinical significance of active scars. Rehabilitace a fyzikalni lekarstvi. Czech J Rehabil Phys Ther. 2003;10:129–132[Prague, Czech Republic]
  2. Richardson J, McGurgan P, Cheema S, Prasad R, Gupta S. Spinal endoscopy in chronic low back pain with radiculopathy. A prospective case series. Anaesthesia. 2001;56:454–460
  3. Isla A, Alvarez F. Spinal epidural fibrosis following lumbar diskectomy and antiadhesion barrier. Neurocirugia (Astur). 2001;12:439–446
  4. Farber MA, Krasnov IuP, Magai NV. Pathogenetic significance and diagnosis of adhesive processes in the radicular syndromes of lumbar osteochondrosis. Zh Nevropatol Psikhiatr Im S S Korsakova. 1988;88:23–25
  5. Shayani V, Siegert C, Favia P. The role of laparoscopic adhesiolysis in the treatment of patients with chronic abdominal pain or recurrent bowel obstruction. JSLS. 2002;6:111–114
  6. Kindermann G, Debus-Thiede G. Postoperative urological complications after radical surgery for cervical cancer. Baillieres Clin Obstet Gynaecol. 1988;2:933–941
  7. Cueto-Rozon R, Bordea A, Barrat C, et al. Is laparoscopic treatment of adhesions a valid approach for postoperative abdominal pain?. G Chir. 2000;21:433–437
  8. Cadeddu JA, Chan DY, Hedican SP, et al. Retroperitoneal access for transperitoneal laparoscopy in patients at high risk for intra-abdominal scarring. J Endourol. 1999;13:567–570
  9. Brill AI, Nezhat F, Nezhat CH, Nezhat C. The incidence of adhesions after prior laparotomy: a laparoscopic appraisal. Obstet Gynecol. 1995;85:269–272
  10. Chen RN, Moore RG, Cadeddu JA, Schulam P, Hedican SP, Llorens SA, et al. Laparoscopic renal surgery in patients at high risk for intra-abdominal or retroperitoneal scarring. J Endourol. 1998;12:143–147
  11. Swanson RJ, Littooy FN, Hunt TK, Stoney RJ. Laparotomy as a precipitating factor in the rupture of intra-abdominal aneurysms. Arch Surg. 1980;115:299–304
  12. Ahcan U, Arnez ZM, Bajrovic F, Zorman P. Surgical technique to reduce scar discomfort after carpal tunnel surgery. J Hand Surg [Am]. 2002;27:821–827
  13. Britto JA, Elliot D. Aggressive keloid scarring of the Caucasian wrist and palm. Br J Plast Surg. 2001;54:461–462
  14. Engert J, Wilhelm K, Simon G. Nerve lesions following injuries of the upper limbs in childhood. Z Kinderchir Grenzgeb. 1980;30(Suppl):117–121
  15. Caprini JA, Arcelus JA, Swanson J, Coats R, Hoffman K, Brosnan JJ, et al. The ultrasonic localization of abdominal wall adhesions. Surg Endosc. 1995;9:283–285
  16. Babar S, Saifuddin A. MRI of the post-discectomy lumbar spine. Clin Radiol. 2002;57:969–981
  17. Bradley WG. Use of contrast in MR imaging of the lumbar spine. Magn Reson Imaging Clin N Am. 1999;7:439–457
  18. Ross JS, Obuchowski N, Modic MT. MR evaluation of epidural fibrosis: proposed grading system with intra- and inter-observer variability. Neurol Res. 1999;21(Suppl 1):S23–S26
  19. Gutt CN, Oniu T, Schemmer P, Mehrabi A, Buchler MW. Fewer adhesions induced by laparoscopic surgery?. Surg Endosc. 2004;18:898–906
  20. Huneke F. Krankheit und Heilung anders gesehen. Koln, Germany: Staufen; 1947;
  21. Simons DG, Travell JG, Simons LS. In: 2nd ed. Myofascial pain and dysfunction: the trigger point manual. vol. 1:Baltimore: Williams&Wilkins; 1999;p. 43
  22. Lewit K, Olsanska S. Clinical significance of active scars: abnormal scars as a cause of myofascial pain. J Manipulative Physiol Ther. 2004;27:399–402
  23. Robbins S, Cotran R. In: Pathologic basis of disease. 2nd ed. Philadelphia: WB Saunders Co; 1979;p. 94–95
  24. Morris C, Chaitow , Janda V. Functional examination of low back syndromes. In:  Morris C editors. Low back syndromes: integrated clinical management. New York: McGraw-Hill; 2006;p. 387–391
  25. Hildebrand KA, Frank CB. Scar formation and ligament healing. Can J Surg. 1998;41:425–429
  26. Bergholm U, Johansson BH. New diagnostic approach can improve treatment of whiplash injuries. Functional magnetic resonance tomography makes visualization of the injuries possible. Lakartidningen. 2003;100:3842–3847
  27. Hertel J. Functional instability following lateral ankle sprain. SportsMed. 2000;29:361–367
  28. Dosch P. Lehrbuch der neuraltherapie nach Huneke. Ulm, Germany: Haug; 1964;
  29. Gross D. Therapeutische lokalanaesthesie. Stuttgart, Germany: Hippokrates; 1972;
  30. Lewit K. The needle effect in the relief of myofascial pain. Pain. 1983;6:83
  31. Lewit K. Treatment of the scars. In:  Lewit K editors. Manipulative therapy in rehabilitation of the locomotor system. 3rd ed. Oxford: Butterworth-Heinemann; 1999;p. 153
  32. Lewit K. Role of manipulation in spinal rehabilitation. In:  Liebensen C editors. Rehabilitation of the spine: a practitioner's manual. Baltimore: Lippincott Williams and Wilkins; 1996;p. 195–224
  33. Lewit K, Kolar P. Chain reactions related to the cervical spine. In:  Murphy DR editors. Conservative management of cervical spine syndromes. New York: McGraw-Hill; 2000;p. 515–530

PII: S0161-4754(07)00050-4

doi: 10.1016/j.jmpt.2007.01.005

Journal of Manipulative and Physiological Therapeutics
Volume 30, Issue 3 , Pages 234-238 , March 2007