Subluxation Case Study

7/29/2019 Subluxation Case Study

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INTRODUCTION

The word subluxation means a slight dislocation or biomechanical malfunctioning of the

vertebrae (the bones of the spine). Subluxation can be simply thought of as an alteration of the

normal joint structural alignment or function, since altered position causes altered motion.

Vertebral subluxation is specific to any of the five regions of the axial skeleton (cervical, thoracic,

lumbar, sacral, and pelvis). Extraspinal subluxation denotes the articulations of the extremities,including the foot, ankle, knee, hip, shoulder, elbow,wrist, hand, anterior ribs and head. Spinal

subluxation is usually caused by an injury to the ligaments that hold the vertebrae together.

These 6 types of subluxation are mechanical descriptions for the allowable spinal desplacements.

1. Segmental subluxations2. Postural main motion and coupled motion3. Snap-through buckling in the sagittal plane4. Euler buckling in AP/PA view5. Scoliosis6. Static or dynamic segmental instability

Vertebral subluxations have a great number of different causes all of which the averageindividual is exposed to daily. These causes can be described in terms of physical, chemical, andemotional causes.

Physical causes include acute trauma to the body, repetitive motions affecting the spine, bad postural

habits, improper workstation habits and design, and weak or imbalanced spinal musculature.

Chemical causes include poor dietary and nutritional practices, drug and alcohol use and abuse, and

the ingestion of chemical toxins in the foods we eat, air we breath, and water we drink. Chemicals

which are harmful to the body decrease the body's ability to function optimally and reduce the abilityto successfully adapt to and withstand internal and external stresses - making us more susceptible to

spinal subluxations and the consequences of these subluxations.

Emotional causes refer to stress. Excessive stress or inadequate stress management skills can deplete

the body of the ability to sustain normal functions. The impact of emotional stress on physical health

is well documented in the medical research and can have devastating effects on the immune system,

making the body susceptible to injury and disease.

Signs and Symptoms are commonly associated with the vertebral subluxation and include:

neck pain, tenderness, soreness and stiffness back pain, tenderness, soreness and stiffness headaches dizziness or balance problems spinal muscle spasm, tightness or weakness reduced spinal mobility pain, numbness or tingling in the extremities joint pain and stiffness low energy poor overall state of health poor tissue healingThe detection of spinal misalignments (subluxations) by the chiropractic profession has relied on X-ray

findings and physical examination. At least 2 of the following 4 physical signs and/orsymptomsmust be

documented to qualify for reimbursement:
http://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Symptoms


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Pain and tenderness Asymmetry/misalignment Range of motion abnormality Tissue/tone changes

PATIENTS PERSONAL DATA

NAME: CMD

AGE: 5 years old

GENDER: Female

ADDRESS: brgy. San juan antipolo city.

OCCUPATION: N/A (still a student)

NATIONALITY: Filipino

CIVIL STATUS: Single

RELIGION: Roman Catholic

FINAL DIAGNOSIS: Close subluxation; C2

C3 spondylolisthesis

ATTENDING PHYSICIAN : Dr. Chua

DATE ADMITTED: dec. 17, 2011

TIME ADMITTED: 4:30pm

NURSING HISTORY

Present Health History:

Two weeks prior to admission while the patient was playing, she accidentally fall from a

height of five feet hitting her right shoulder first followed by the neck as claimed by the patient.

Patient immediately complained of neck pain and stiffness that was relieved by rest. There was no

lost of consciousness, no numbness, headache, nausea and vomiting. At home manual

manipulation of the neck was done which afforded no relief. There was no consult or any

medications taken.

One week prior to admission, due to persistence of neck stiffness, patient was brought to our

institution for further evaluation and management. patient was given medication and were advised

for x- ray and other laboratory exams. Patient was advised to follow up one week after, but

patient was lost to follow up. Persistence of above symptoms prolonged parents to seek medical

consult, hence was admitted.

Past Health History:

According to the SO of the patient the patient did not yet experienced having serious

health problems other than fever, colds and cough. He had no previous hospitalization.

Family medical history:

No known history of bronchial asthma, pulmonary tuberculosis, diabetes mellitus and allergy.


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Laboratory Findings

Hemoglobin 1

13.518.5 g/dL Decreased due to poor

oxygen supply

Hematocrit 3

4054% Decreased due to poor

oxygen supply

Red Blood

Cells

4.

4.06.0 10^ 6/

uL

Normal

Mean

corpuscu

lar

hemoglobin

2

2634 pg Normal

Mean

corpuscu

lar

volume

7

80100 fL Normal

Mean

corpuscu

lar HGB.

CONC.

3

3137 g/dL Normal

White Blood

Cells:

8.

4.511.0 10^3

uL

Normal

-

Neutrop

hils

0.

0.450.65 Decreased because of

presence of

microorganism

-

Lympho

cytes

0.

0.200.35 Increased because of

presence of

microorganisms

- Monocytes 0.

0.02

0.06 Normal

Platelet 1

150350 10^

3/uL

Decrease presence of

hemolysis


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Discharge Plan

Keep a current list of your medicines: Include the amounts, and when, how, and why you take them.Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an

emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as

directed.

Take your medicine as directed: Call your primary healthcare provider if you think your medicine isnot working as expected. Tell him about any medicine allergies, and if you want to quit taking or

change your medicine.

Pain medicine: You may need medicine to take away or decrease pain.o Learn how to take your medicine. Ask what medicine and how much you should take. Be

sure you know how, when, and how often to take it.

o Do not wait until the pain is severe before you take your medicine. Tell caregivers if yourpain does not decrease.

o Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you getout of bed or if you need help.

CONTACT A CAREGIVER IF:

You have a fever. You see a skin rash, redness, or sores under your brace. You have problems swallowing while you are wearing your halo brace. Your neck pain is not getting better even with treatment. You have questions or concerns about your cervical fracture, medicine, or care.SEEK CARE IMMEDIATELY IF:

You have a sudden, severe headache with nausea and vomiting. You are seeing double or cannot see out of one eye. You cannot stay awake. The pins in your halo brace have loosened or look deeper in the skin than before. You feel new weakness or numbness in your hands or fingers. You are having trouble breathing. You cannot feel or move your arms or legs. You have chest pain or trouble breathing that is getting worse over time. You suddenly feel lightheaded and have trouble breathing. You have new and sudden chest pain. You may have more pain when you take deep breaths or

cough. You may cough up blood.

Your arm or leg feels warm, tender, and painful. It may look swollen and red.


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Subluxation Case Study

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