Foraminal stenosis with radiculopathy from a cervical disc herniation in a 33-year-old man treated with flexion distraction decompression manipulation

J Manipulative Physiol Ther. 2008 Jun;31(5):376-80. doi: 10.1016/j.jmpt.2008.04.002.


Objective: The purpose of this report was to describe the use of Cox flexion distraction decompression manipulation on a patient with radiculopathy from a C6/C7 disc herniation.

Clinical features: A 33-year-old man complained of severe neck pain and spasms, pain radiating down his left arm and upper back, and associated numbness in his fingers. Cervical spine plain film radiographs showed mild C6/C7 osseous degenerative changes. Cervical magnetic resonance imaging revealed a moderate-sized left posterolateral disc herniation at C6/C7 causing severe foraminal stenosis.

Intervention and outcome: Treatment consisted of Cox flexion distraction decompression manipulation and adjunctive physiotherapy modalities. The patient was treated a total of 15 times over a period of 10 weeks. Subjective findings using a pain scale and objective examination findings supported a good clinical outcome. At 2-year follow-up, subjective and objective findings remained stable.

Conclusion: This study reports Cox flexion distraction decompression manipulation and physiotherapy modalities showed good subjective and objective clinical outcomes for this patient.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Cervical Vertebrae*
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis
  • Intervertebral Disc Displacement / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Manipulation, Spinal / methods*
  • Neck Pain / diagnosis
  • Neck Pain / etiology
  • Pain Measurement
  • Radiculopathy / diagnosis
  • Radiculopathy / etiology
  • Radiculopathy / therapy*
  • Range of Motion, Articular / physiology
  • Risk Assessment
  • Severity of Illness Index
  • Spinal Stenosis / etiology
  • Spinal Stenosis / therapy*
  • Treatment Outcome