Anterior head translation following cervical fusion-a probable cause of post-surgical pain and impairment: a CBP® case report

J Phys Ther Sci. 2018 Feb;30(2):271-276. doi: 10.1589/jpts.30.271. Epub 2018 Feb 20.


[Purpose] To present the case of the dramatic reduction in pain, disability, and neurologic symptoms following the reduction of forward head translation and increased cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip strength for 12 years following a C5-C6 cervical discectomy and fusion. Outcome measures included the neck disability index, the numerical pain rating scale, and the Zebris cervical range of motion system. Radiographs and computerized posture analysis revealed excessive forward head posture. Initial traditional 'symptom-relief' chiropractic rehabilitation was provided, followed by CBP® structural rehabilitation of head and neck posture with a 2.5 year follow-up. [Results] The initial traditional chiropractic rehabilitation did not improve posture or disability scores. CBP methods resulted in radiograph-verified postural alignment improvements corresponding with clinically significant improvements in the patient's neurologic condition, pain and disability scores. These results were maintained at a 2.5 year follow-up with minimal treatment. [Conclusion] Patients with post-surgical axial symptoms and/or radicular complaints should be screened for altered cervical alignment and anterior head translation. Future studies should attempt to duplicate these positive results in a trial with long-term follow-up.

Keywords: CBP; Cervical fusion; Forward head posture.