MANIPULATION IN LUMBAR INTERVERTEBRAL DISC PROTRUSION

Although more effective, forceful manipulation is often painful. Poor muscle relaxation also causes difficulty in manipulation. Manipulation with intravenous anesthesia and muscle relaxation renders better results. Hot herb medicine compresses before manipulation and pelvic traction between manipulations are helpful. For huge protrusion of nucleus pulposus, central disc or spinal stenosis, surgery is indicated.202 cases of protrusion of lumbar intervertebral disc treated with forceful manipulation under anesthesia are reviewed. Of 86 cases followed up, good results were obtained in 84.9% with recurrence in 7%.The procedure involved chiefly pelvic traction, hyperextension, hyperflexion and waist rotation.In some cases surgical enucleation and decompression are still mandatory.