The purpose of this article is to demonstrate the effectiveness of the Pettibon Spinal Correction System.

Clinical Features and Methods
A patient was diagnosed with mechanical neck and low back pain and was classified according to the Pettibon System as having a posture pattern No. 3. A No. 3 posture is one with a lateral head shift and an uncompensated subluxation pattern. Hip deviations are associated with A-P head and lateral spine postures. Eyes and shoulders are level. This pattern illustrates classic torn ligaments.

Examination procedures include taking the following measurements: patient height, respiration, blood pressure, posture analysis, range of motion, and neurological evaluation for cervical and lumbar coupled motion. Posture patterns and examination findings are correlated to an initial seated seven-view Pettibon radiographic series. A patient-specific care plan was designed correlating subjective and objective findings.

Treatment
The program consisted of spinal rehabilitative procedures that involved using the Pettibon Weighting System. The care period consisted of daily visits for the first 2 weeks, followed by three times per week for another 10 weeks. Care was then reduced to twice weekly for another 12 weeks, and then once per week thereafter. This care program was based on re-exams performed every 12th visit and re-x-rays at 3-month intervals, or as soon as visible postural changes were apparent.

Initial x-ray findings demonstrated a reversed cervical curve (–9° or a 122% loss). Right lateral occiput and cervical translation. Forward head carriage was 35 mm.

Findings showed a 3° left upper angle, a 4° right lower angle, a 10° left cervico-dorsal angle, a 3° left dorsal-upper dorsal angle, a 9° right dorsal-lower dorsal angle, a 4° left lower dorsal angle, and a left 5° lumbosacral angle.

The lumbar lordosis was reduced by 49% to 18°. Cervical flexion was reduced to 16°, and extension was 37°.

Re-x-ray at 6 weeks revealed a 50% improvement in cervical lordosis. Flexion improved to 50 ° (N=60) and extension to 66 (N=80).

At the end of 6 months, all lordotic curves were fully restored and the A-P angles were reduced to within normal limits of between 0° and 1°. Forward head carriage was corrected. The lumbo sacral gravitational weight line was restored. Improvements in blood pressure, spirometry, disk height, and overall height were also documented.

Care Plan
The care protocol was a comprehensive program consisting of specific warm-up exercises, spinal correction, neuromuscular re-education, and rehabilitative exercises.

The warm-up exercises, performed on a Pettibon Wobble Chair and the Repetitive Cervical Traction, are designed to stretch the muscles, ligaments, and disks to isolate active motion to the lumbar and cervical spine and its associated structures. The goal of these exercises is to decrease the amount of hysteresis in the white tissues so that the manipulative procedures can overcome this stored energy and focus more on mobilizing the spinal joints effectively. The spinal manipulative procedures used were a combination of a negative-Z adjustment for the restoration of the cervical lordosis and an extension subluxation of skull on atlas; as well as Y and Y-A decompressive occipital and cervical adjustments, an anterior thoracic adjustment applied to the T7-T11 area, and a side posture sacral-specific adjustment performed bilaterally.

Spinal manipulative procedures were used in conjunction with active spinal rehabilitation to mobilize all of the cervical, lumbar, and sacroiliac joints so that the rehabilitative exercises and neuromuscular  re-education could have a quicker and more immediate effect.

For neuromuscular re-education, a Pettibon anterior head weight was used to force the body to realign the entire spine closer to the center of gravity, through neurological adaptation. In conjunction with the anterior head weight, the patient also wore shoulder weights over the low shoulder. Hip weights were placed around the patient’s waist. This weight placement allowed for correction of the lumbar lordosis and improvement in the scoliotic curve. The strengthening phase of the patient’s care consisted of rehabilitative exercises performed on the Pettibon Linked Trainer. The exercises prescribed were specific to the spinal configuration present on the patient’s radiographic film. This machine involves improving postural-muscle balance, strength, and endurance through isometric exercises. The exercises are performed unilaterally to cause isometric contractions to strengthen the specific weak muscle, thereby rotating and laterally flexing the spine back into alignment.

In addition to the standard office visits, the patient was required to perform specific home rehabilitative care to complement the corrective program.

 Home care consisted of using the Pettibon Wobble Chair, Repetitive Cervical Traction, and Body Weighting System for 20 minutes twice daily, and lying on a set of high-density foam blocks called spinal molding once daily for 20 minutes immediately prior to bed.

Additionally, home core strengthening exercises were performed while on foam blocks, which support the cervical and lumbar lordosis during exercise.

The Pettibon System requires that the doctor understand that the most important vertebrae in the body is the skull. The Pettibon System uses the body’s own innate wisdom to restore and correct subluxations and to maintain their correction. The Pettibon promise is to provide health care that enables the human spine to maintain its optimal structure for normal function.

Jeffrey Ptak, DC, has practiced in Los Angeles since 1985. Contact him at in8one@earthlink.net.

Shalese Madison, DC, practices in Los Angeles. Contact her at (310) 473-7991.