J Manipulative Physiol Ther. 1996 Oct; 19(8): 539-51.

Management of the patient with a Chance fracture of the lumbar spine and concomitant subluxation.

Plaugher G, Alcantara J, Hart CR.

Palmer College of Chiropractic West, San Jose, CA 95134, USA.

OBJECTIVE: To document the chiropractic management of a patient who sustained a Chance fracture of the third lumbar vertebra. This case study represents the first report in the scientific literature of such an injury managed through chiropractic methods. CLINICAL FEATURES: An 18-yr-old man complained of low back pain and paresthesia in the lower extremities 10 days after suffering an automobile accident. Examination revealed a large circular edematous area from L1 to L4, tenderness to palpation at the L3 spinous process, reduction in global range of motion at the thoracolumbar region, and positive LasÃ¨gue and Kemp tests (bilaterally). Radiographic and computed tomographic scans revealed a Chance fracture of the L3 vertebra. INTERVENTION AND OUTCOME: The patient received specific-contact, short-lever arm spinal adjustments delivered primarily at L3 and L5, as well as bracing. Four months after initial treatment, the patient's complaint of paresthesia had resolved and he suffered only occasional minor low back pain. The comparative radiographs demonstrate a reduction in the separation of the fracture fragments. CONCLUSION: A case report is presented of a patient who suffered a Chance fracture of L3. The patient was eventually managed by chiropractic methods including a specific contact high-velocity thrust procedure administered at the level of the fractured vertebra. The case represents the first known reporting of this type of chiropractic procedure applied to a patient with a Chance fracture.