From: MARK TRAMO

From: MARK TRAMO To: Jeffrey Epstein <1 Cc: Subject: M. - journal article and other info about PTx for Spondylisthesis Date: Sun, 24 Jun 2018 20:12:20 +0000 Attachments: LSspondylisthesisPTx.Kim2018Medicine.pdf Please see attached PDF, especially the references (the paper itself is a clinical research proposal for a prospective study on effectiveness of conservative Tx for spondylisthesis. AN informative paragraph: According to the results of our previous observational study involving Mokhuri nonsurgical integrative treatments performed on patients diagnosed with Meyerding grade 2 lumbar spinal spondylolisthesis, considerable clinical improvement was observed after nonsurgical integrative treatments; the average walking distance without pain increased from 55 to 165m, while the intensity of pain experienced when walking was reduced by 80% compared with the baseline assessment.[?] In another previous retrospective audit study, on a numeric rating scale from 0 to 10, 44 spondylolisthesis patients reported a reduction in numeric rating scale scores from 7.1 to 3.1, and walking distance without pain increased from 193 to 568m after treatment.m These observational studies provide clues for the potential benefit of nonsurgical integrative treatments and suggest that these treatments might be effective for pain relief and functional restoration in patients with symptomatic lumbar spinal spondylolisthesis. However, observation studies cannot provide clinical evidence, so these new therapeutic options should be evaluated through rigorous, high-powered clinical trials. Other links - informative, but not published in peer-reviewed professional journals - since PTx has to be individualized, the utility of blinding, randomizing, etc is questionable. Both these say to AVOID "extension exercises". http://www.sosmed.oreprotocols/pt-protocols/nnesc/NNESC-LUMBAR-SPONDYLOLYSIS.pdf Mark Jude Tramo, MD PhD Dept of Neurology, David Geffen School of Medicine at UCLA Dept of Musicology, UCLA Herb Alpert School of Music Director, The Institute for Music & Brain Science Co-Director, University of California Multi-Campus Music Research Initiative (UC MERCI) http://www.BrainMusic.org http://merci.ucsd.edu EFTA00477021