This case report describes a 28-year-old female patient who experienced severe neurological symptoms after undergoing surgery to remove a thoracic astrocytoma tumor and laminectomy. She experienced constant paresthesia, numbness, and difficulty with daily activities. Application of Sacro-Occipital Technique Category I blocks immediately relieved her severe buzzing sensation in the lower extremities for up to 12 hours. The blocks are believed to have reduced tension and torsion in the spinal cord and improved cerebrospinal fluid circulation, reducing her symptoms. The patient experienced marked improvement in her symptoms, reduced need for medications, and improved quality of life with repeated application of the Category I blocks.
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Using SOT Blocks to Remove Symptoms from Astrocytoma Surgery
1. RELIEF OF NEUROLOGICAL SYMPTOMS SECONDARY
TO SURGICAL REMOVAL OF THORACIC
ASTROCYTOMA BY CATEGORY 1 BLOCK PLACEMENT:
A CASE REPORT
WILLIAM J. BORO, DC, CC, DICS
3. PURPOSE OF THIS PRESENTATION
To describe the clinical course, treatment, and positive response of a female
patient suffering from symptoms secondary to postsurgical laminectomy and
resection of a thoracic pilocytic astrocytoma.
The application of Sacro-Occipital Technique™ Category I blocks immediately
and repeatedly relieved severe, constant paresthesia, a sense of buzzing, in
her lower extremities.
Provide a theoretical understanding of why Category I block placement was
effective in this case.
4. WHAT IS A PILOCYTIC ASTROCYTOMA?
AKA Juvenile pilocytic astrocytoma
Most common CNS neoplasm of
childhood
Cases over the age of 30 are rare
Low grade, localized and slow-growing
Considered benign with a favorable
prognosis
Intramedullary
Diseases of the spine and spinal
cord,
p. 225
Intradural
extramedullary
Diseases of the spine
and spinal cord, p.
209
Epidural
www.stritch.luc.edu
6. PATIENT INFORMATION
5’5”, 115 pound, 28 year old nulliparous female
Two weeks of upper back pain at night
Electric shocks down left side when moving head
Foot jerked off the gas pedal when turning head to
change lanes
Surgical removal of 4” long thoracic pilocytic
astrocytoma with T4-T7 laminectomy
10% of tumor was left in situ
Post surgery unable to walk for 2 weeks
7. PATIENT SYMPTOMS POST-LAMINECTOMY
PRIOR TO CHIROPRACTIC TREATMENT
Constant low back pain & rib
instability
Neuropathy
Pain and numbness in both legs
Pain and cramps in both feet
Paresthesias (e.g.,Buzzing in legs)
Difficulty with activities
Pushing or getting in and out of
car
Sitting at a table
Visceral dysfunction
Constipation with inability to
defecate without pharmaceutical
intervention
Projectile vomiting
No menstrual periods
Vaginal numbness
8. COMMON POST-SURGICAL OUTCOMES
Total recovery time from 3-12
months
Some patients develop new
numbness or tingling pain which
sometimes is worse than the pain
before surgery
From spinalcordtumor.org
In 2014 study of 69 patients,
neurological states
Improved in 23.2%
Unchanged in 68.1%
Aggravated in 8.7%
Functional outcomes
Good in 75.4%
Fair in 14.5%
Poor in 10.1%
From Neurological Outcome after Surgical Treatment of ISCT (Lee, Cho, Kwon)
10. CHIROPRACTIC PHYSICAL THERAPY
Cranium
Full spine
Extremities and ribs
Soft tissue release techniques
around the incision
Visceral adjustments
SOT Category III, II and I blocking
Aquatherapy
Physical Therapy
11. CATEGORY I BLOCKING RESULTS
There was an immediate (within 5 minutes) cessation of the “buzzing” in her
legs
Cessation of buzzing lasted up to 12 hours
Patient took blocks home and has been able to do more activities of daily
living with less buzzing
13. DURAL ATTACHMENTS
The dura attaches firmly to the cranium and the sacrum
There are also attachments in the cervical and lumbar spine
14. ADVERSE MECHANICAL TENSION IN THE
CENTRAL NERVOUS SYSTEM
Alf Breig states that if tension is created in the pons cord tract it can result in
symptoms of neurological deficit or excitation and hyper- or hypo-function of
various organs
“…symptoms from a localized lesion may be relieved to a greater or lesser
extent when the pons cord tract is rendered slack.”
15. WHAT CAUSES COMPRESSION TINGLING?
Mechanical deformation
Oxygen lack
Accumulation of local metabolites
Lowering of threshold to stimulation of the
nerve by any of the above causes
Combination of these causes
Pins & Needles, Weddell,
1946
16. WHAT DOES CATEGORY I BLOCKING ACCOMPLISH?
Category I
Corrects rotational malposition of pelvis
Relaxes paraspinal musculature
Calms proprioceptors
Affects spinal dural tension and traction on spinal nerves
Removes dural torque
Aligns dural ports
Frees minor dural port constrictions
17. SO HOW DOES IT WORK?
Tensions, torsions and deformations created by spinal and dural scar tissue
cause buzzing and increased sensitivity around the laminectomy scar
Blocking:
Releases cord tension and torsion
Creates better CSF fluid circulation
Increases removal of waste metabolites
Improves oxygenation
Category I blocking creates a relative flexion/extension release of the sacrum
20. REDUCTION OF SYMPTOMS
More feeling in feet
Diminished low back pain
Increased rib stability
Marked improvement in balance
No longer needing a walker
Relief of buzzing paresthesia within
5 minutes using blocks
Reduced need of medications
Improved bowel function
Menstrual periods began again
21. CONCLUSION
It appears that there may be a subset of patients suffering from paresthesia secondary to
post surgical spinal cord tumor removal and laminectomy who will respond to the
application of Category I blocking.
This patient’s response to care suggests a potential boon to others who suffer from this
horrible condition.
Caution about generalizing these results to other patients is advised.
Condition has improved, the improvement is sustained, and that when symptoms recur,
they respond quickly to this application is suggestive that this therapy is the cause of
improvement.
It is hoped that this study will generate greater interdisciplinary interest and cooperation
so that patients suffering with this condition may have an alternate choice of treatment
with reduced need of prescription medications.
reference to dural attachments in cervical of ligamentum nuchae to posterior spinal dura;
dural connections to rectus capitis posterior minor and major muscles as welll as obliquus capitis inferior muscles.
In the thoracic and lumbar regions there are ligaments of hoffman extending from the posterior longitudinal ligament to the spinal dura.
At the anterior sacral region troland's ligaments anchor the spinal dura in addition to ligaments of hoffman.