Chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae

Abstract

Objective: The purpose of this study is to report the chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae (LSTV).

Clinical features: A patient with previously undiagnosed LSTV presented with moderate low back pain.

Interventions and outcome: Manual therapy, soft tissue therapy, and exercise/stretching were included in the initial treatment plan. Following a short course of treatment, the presenting symptoms resolved; however, they returned after 3 symptom-free months. At that time, radiographs were ordered and the LSTV were identified. Following another course of chiropractic care, the patient's symptoms resolved.

Conclusions: Chiropractic management resulted in resolution of symptoms for this patient with LSTV.

Keywords: Chiropractic congenital abnormalities; Lumbar vertebrae; Lumbosacral region.

Figures

Fig 1

Anterior-posterior plain film of the lumbar spine. Arrows indicate the large transverse processes on the L5 vertebra.

Fig 2

Lateral plain film of the lumbar spine. No anomalies in the transverse processes are visible.

Fig 3

A and B, Bilateral plain films focusing on the L5/S1 junction. A, Right anterior-posterior view of the oversized L5 transverse process (white arrow). The sacroiliac joint space is well preserved. B, Left anterior-posterior view of the oversized L5 transverse process (white arrow). Note the accessory articulation visible between the L5 transverse process and the sacrum (black arrow). The sacroiliac joint space is well preserved.