Dysplastic Lumbar Spondylolysis Presenting As Hyperventilation Syndrome in a Young Man
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 4, Issue 4
Abstract
Many causes contribute to hyperventilation; however, the pathophysiology involved is still unknown, and the skeletal origins of the condition have scarcely been examined. We present a case of a 20-year-old man with a history of hyperventilation and subtle lower back pain due to spondylolysis of the fifth lumbar vertebra with grade I spondylolisthesis. The duration and frequency of hyperventilation increased after performing physical modality and abated after discontinuing physical modality. We discuss the relationship and associated pathophysiology between hyperventilation and spondylolysis, which is the first report in the literature. We suggest that physical therapy might be harmful for some patients with hyperventilation, because the hyperventilation might be a clinical manifestation of dysplastic lumbar spondylolysis. Hyperventilation, defined as breathing in excess of metabolic requirements, is associated with a reduction in arterial PaC02 and respiratory alkalosis, as well as a wide range of symptoms. Many causes contribute to hyperventilation syndrome; however, the pathophysiology involved is still unknown, and the skeletal origins of the condition have scarcely been examined [1]. We present the case of a 20-year-old man with a history of hyperventilation and subtle lower back pain due to spondylolysis of the fifth lumbar vertebra with grade I spondylolisthesis. The duration and frequency of hyperventilation increased after performing physical modality (short wave diathermy and electric stimulation therapy). After discontinuing physical therapy, the hyperventilation abated. We discuss the relationship and associated pathophysiology between hyperventilation and spondylolysis. A 20-year-old soldier without history of major trauma experienced subtle lower back pain for 2 years since 2008. Half a year prior, he suffered from shortness of breath with near-syncope for several minutes after standing guard in 2010. A series of examinations did not show any specific findings, except a low PaCO2; hyperventilation syndrome was considered. Due to intermittent subtle lower back pain, he was referred to our rehabilitation clinic for help on 2010/10/12. Physical examination revealed pain during trunk extension and poor balance when standing on a single leg. Plain X-ray films of the lumbar spine showed bilateral spondylolysis of the fifth lumbar vertebra, together with grade I spondylolisthesis, and the ensuing computer tomography confirmed the lumbar pathology (Figure 1).
Authors and Affiliations
Shin-Tsu Chang
Keywords
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- EP ID EP590934
- DOI 10.26717/BJSTR.2018.04.001071
- Views 155
- Downloads 0
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