Donald Corenman, MD, DC
Moderator
Post count: 8660

Hypo-mobility can increase the stress on joints above and below. This can lead to hyper-mobility in the case of a degenerative spondylolisthesis (DS) at L4-5 above an isolated disc resorption at L5-S1.(See https://neckandback.com/conditions/isolated-disc-resorption-lumbar-spine-idr/). That scenario however would be unusual. Normally, the hypo-mobile joint will increase the stress of the level above and lead to degeneration but not hyper-mobility.

I think manipulation’s value is in keeping mild-moderately degenerative segments moving. The severe degenerative in segments with DS or degenerative scoliosis is an exception. I believe that these segments should not be mobilized in patients with radiculopathy or neurogenic claudication. In the case of degenerative spondylolisthesis, the mobilization of this segment can allow more slip and worsening of the canal compression. In degenerative scoliosis, the spine needs to stiffen to prevent further curve collapse and I think that manipulation might hasten the increase of the curve’s magnitude.

Dr. Corenman

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Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.