200 Section - Osteopathic Manipulative Treatment and Its Effect on a Post-Neurosurgical Complication: A Case Study

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

NR

Naomi Reyes, MS

Medical Student
A.T. Still University, School of Medicine in Arizona
Tucson, Arizona, United States

Co-Author(s)

MM

Melchiorra Mangiaracina, DO

Assistant Professor of Osteopathic Principles and Practice/Attending
A.T. Still University, School of Medicine in Arizona
Mesa, Arizona, United States

Case Diagnosis: In this case study, a 73 year-old male post-cranioplasty presented to the clinic with a nonhealing head wound.

Case Description: A 73-year-old male with a past medical history of a subdural hematoma status post burr hole placement complicated by osteomyelitis requiring bone flap explantation and polymer prosthesis re-implantation presented with a superimposed surgical site nonhealing head wound with worsening serous drainage 2.5 months post-cranioplasty despite undergoing hyperbaric oxygen therapy and IV antibiotics. Serial osteopathic manipulative treatments (OMT) were performed alongside speech, occupational, and physical therapy. OMT was applied to ten different body regions. After the initial session, he reported decreased wound discharge and improved mentation. Over 2.5 months, the number of body regions needing treatment decreased from ten to six. Occupational and physical therapy recommended early discharge while speech therapy outcomes showed improvement in memory, visuospatial abilities, language and attention. His wound size stabilized around 1.25x1 inches and a follow-up CT head without contrast showed a complete reduction in a prior left-sided 13 mm subdural fluid collection.

Discussions: Research regarding OMT directed towards the lymphatic system suggests improved wound healing through increased lymphatic flow, mobilization of white blood cells, and managing inflammation. Other literature suggests that OMT optimizes the glial lymphatic system through better CSF clearance and interstitial waste product removal. Through the application of OMT, the patient’s outcomes suggested improved lymphatic flow, cranial bone motion, and overall homeostasis resulting in enhanced wound healing, better functionality, and greater respect for patient autonomy.

Conclusions: Despite minimal research regarding OMT for post-neurosurgical patients, recent literature suggests interests for OMT integration into practice pending further supportive findings. This case study provides an example as to how OMT can be used as an adjunctive therapy to traditional interventions for neurosurgical patients to improve post-surgical outcomes, complications, and overall patient functionality.