Reducing thoracolumbar kyphosis: Structural, postural, and spinal rehabilitation case report with a 5-year follow-up

Abstract

Purpose: To present the successful outcome of a patient with 2 extra vertebrae having spinal deformity. Participant and methods: A 29-year-old female presented with chronic low back pain. Uniquely, the patient demonstrated 2 extra vertebrae, 13 rib bearing vertebrae and 6 non-rib bearing lumbar vertebrae. Radiography assessment demonstrated an exaggerated thoracolumbar kyphosis. Treatment was given to reduce the deformity using spinal rehabilitation and postural rehabilitation methods. Extension traction for the deformity was given as well as corrective exercises and spinal manipulative therapy. Results: After 31 treatments there was dramatic reduction in pain, disability, quality of life and improved X-ray parameters. Following another 24 treatments, the patient reported to be well demonstrated a 14° reduction in thoracolumbar kyphosis and a 50 mm reduction in posterior thoracic translation. A 5-year follow-up showed only slight regression of both deformity and symptoms. Conclusion: This case has demonstrated that patients with an atypical number of vertebrae can benefit from structural spinal rehabilitation and experience improved spinal alignment and reported outcomes. The improved sagittal spine alignment corresponded with the dramatic reduction in chronic pain, disability and improved quality of life. Routine radiographic screening is necessary to diagnose atypical anatomical variants which can and should alter treatment approaches.

Keywords

• Spine anatomical variant
• Extra vertebrae
• Thoracolumbar kyphosis