One recent study explored the case of a 29-year old man with a previously undiagnosed spinal anomaly called lumbosacral transitional vertebrae (LSTV).
The man started experiencing back pain after increasing his physical activity heavily while training for a new job in law enforcement. He was treated with a standard course of chiropractic care including spinal manipulation, mobilization, soft tissue therapy, and trigger point therapy. He reported his low-back pain and referred leg pain significantly improved. However, three months later his symptoms returned worse than before. Orthopedic testing revealed no changes from the previous assessment so radiographic imaging was ordered of his lumbar spine and sacroiliac joint.
Doctors discovered the man had a congenital vertebral anomaly called a lumbosacral transitional vertebrae (LSTV). Congenital vertebral anomalies develop in the womb, and cause the spine to become malformed. Often these anomalies are not clinically important, however they can compress the spinal cord or vertebral canal in some cases. Researchers were unable to confirm whether this was the precise cause of the man’s pain, however earlier studies have pointed to a link between LSTV and an increased risk of early disc injury.
After identifying the LSTV, chiropractors treated the patient with spinal mobilization, soft tissue therapy, and more intensive myofascial release therapy. The man reported a resolution in pain after the additional chiropractic care. This case study adds to another former case study showing the benefits of exercise therapy and chiropractic for relieving symptoms in patients with LSTV.
Since there are very few studies on conservative care for LSTV, more research is needed to document the anomaly and its response to conservative treatments. Still researchers wrote that their case study “adds to the literature and provides support for the role of conservative treatment in addressing the biomechanical compensations that may be associated with [LSTV] Castellvi variants.”
Muir, JM. Chiropractic management of a patients with low back pain and Castellvi type II lumbosacral transitional vertebrae. Journal of Chiropractic Medicine 2012; 11(4): 254–259. doi 10.1016/j.jcm.2012.02.005