Peterson CK, RN, DC, MMedEd et al.

Outcomes from MRI–confirmed symptomatic disk herniation patients treated with HVLA SM: A prospective cohort study with 3 month follow-up (F-U). JMPT 2013, 36:461-467.

Comments: This is a very important 2013 paper, the first to document the effectiveness of manipulation for Pts w MRI-confirmed symptomatic cervical disc herniation/radiculopathy. This paper demonstrates that in a large percent of these Pts cervical manipulation resulted in clinically significant in improvement in pain & disability scores. It is a very valuable addition to chiropractic’s database.

Background & Methodology: Study investigates outcomes of 50 Pts w cervical radiculopathy from cervical disk herniation (CDH) Tx w SM. Pts had NP & dermatomal arm pain; sensory, motor, or reflex changes corresponding to the involved nerve root; & at least 1 positive orthopaedic test for cervical radiculopathy. MRI–confirmed CDH linked w Sx was required. Baseline data included 2 numeric rating pain scales (NPRSs), for neck & arm, and t Neck Disability Index (NDI). Pts reevaluated at 2 wks, 1 mo, & 3 mos after Tx for NDI, NPRS & Pt’s global impression of change. HVLA SM were administered by experienced DCs. Acute vs subacute/chronic Pts NPRSs, NDIs, & PGIC were compared.

Results: At 2 weeks, 55.3% were “improved,” 68.9% at 1 month & 85.7% at 3 mos. Statistically significant decreases in neck pain, arm pain, & NDI scores were noted at 1 & 3 mo.

Conclusion: A high proportion of acute & most importantly subacute/chronic Pts w MRI-confirmed symptomatic CDHs Tx w HVLA cervical SM reported clinically relevant improvement at 1 & 3 mo after t first Tx. Of the subacute/chronic Pts, 76.2% reported clinically relevant improv’t at 3 mo. There were no adverse events.