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The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. [1] This procedure can be performed at any level in the spine (cervical, thoracic, lumbar, or sacral) and prevents any movement between the fused vertebrae.
There is also a notable incidence of lumbar spinal fusion patients that present with sacroiliac pain and hypermobility, potentially due to the adjacent lumbar joints being fixed and unable to move. Clinical studies have found up to 75% of post-lumbar fusion patients develop SI joint degeneration within five years of surgery.
Physical therapy primarily includes spinal flexion and extension exercises with a focus on core stabilization and muscle strengthening. In particular, lumbar spondylolisthesis may benefit from core stabilization exercises focusing on lower abdominal, lumbar muscles, hamstrings, and hip flexors, which may temporarily or permanently improve ...
It involves fusion of two or more levels utilizing screws, rods, and an interbody graft. It has a theoretical advantage over instrumented posterolateral fusion (iPLF) in that it provides better support for the vertebra along with several potential neurological benefits, but as of 2011 evidence demonstrating actual improved clinical outcomes was ...
Of these patients, 9 (64%) improved with physical therapy alone. The remaining 5 (36%) improved with injections (steroids or ozone). However, 6 months after the end of treatment, only 5/14 patients (36%) had complete resolution of pain. [52] In a study of 250 patients, medication and physical therapy led to complete pain relief in 51% of patients.
Posterior dislocations is when the femoral head lies posteriorly after dislocation. [5] It is the most common pattern of dislocation accounting for 90% of hip dislocations, [5] and those with an associated fracture are categorized by the Thompson and Epstein classification system, the Stewart and Milford classification system, and the Pipkin system (when associated with femoral head fractures).