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Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation

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Safe physiotherapy interventions in large cervical disc herniations.

Keramat Ullah Keramat¹, Aisling Gaughran

¹Department of Physiotherapy, St Patrick's Hospital, Co. Leitrim, Ireland. karamatjee@yahoo.com

BMJ Case Reports

|August 22, 2012

Summary

Physiotherapy effectively treated cervical radiculopathy caused by a C5-C6 disc prolapse. Thoracic spine mobilization and specific exercises resolved symptoms, avoiding the need for surgery.

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Area of Science:

Neurology
Physiotherapy
Orthopedics

Background:

Cervical radiculopathy often presents with significant pain and neurological deficits.
Conservative management is typically the first line of treatment, but surgical intervention is sometimes required.
A case of cervical radiculopathy due to a large C5-C6 disc prolapse is presented.

Observation:

A 34-year-old woman with C5-C6 disc prolapse and cervical radiculopathy experienced persistent symptoms despite pharmacological treatment.
She was referred for physiotherapy while awaiting neurosurgical consultation.
The patient presented with loss of cervical lordosis and a significant disc prolapse (8x14 mm).

Findings:

Physiotherapy intervention focused on upper thoracic spine mobilization (C7-T6) and a specific cervical extension exercise.
The exercise involved prior voluntary thoracic extension with elevated shoulders.
Symptoms resolved within 3 weeks and 4 sessions, with patients advised to continue exercises at home.

Implications:

This case highlights the potential efficacy of targeted physiotherapy in managing cervical radiculopathy secondary to disc prolapse.
Conservative management, including thoracic mobilization and specific exercises, may obviate the need for surgical intervention.
Further research into physiotherapy techniques for cervical disc herniation is warranted.