“For every action there is an equal and opposite reaction.” Just a physics rule? Not at all! It applies to many things in life, including back pain and neck pain. Adjacent segment disease shows this theory! When back pain is dealt with back surgery, particularly back surgery involving a spinal fusion, the reaction to the action of the fusion is pressure on the spinal segments above and below the surgical area. These are the adjacent segments. These segments accept the work of the surgical segment which they were not created to do. These adjacent segments protest with pain of their own. Lombardy Chiropractic Clinic eases these rebellious adjacent segments with gentle, non-surgical, pain-relieving chiropractic treatment.
WHAT IS ADJACENT SEGMENT DISEASE?
Researchers define adjacent segment disease (ASD) as a “disappointing long-term outcome for both the patient and clinician.” Cervical and lumbar spine adjacent segment disease is reportedly between 2% and 4% a year according to one study. It contributes to reoperation rates after spinal fusion. Risks for ASD are diverse including existing degeneration of adjacent segments, predisposition to degenerative changes, and altered biomechanical forces because of a prior fusion. Non-surgical treatment for adjacent segment disease is the first step as long as progressive neurological deficit is not a problem. (1)
HOW DOES BACK SURGERY INFLUENCE ADJACENT SEGMENT DISEASE RISK?
Types of surgical approaches affect the chances of fusion as well as adjacent segment disease. Total disc replacements (TDR) for neck pain conditions using a ball and socket are designed to maintain motion and reproduce normal motions of the cervical spine. In a surgery for adjacent segment disease in a patient with a TDR, fusion was seen, but adjacent segment disease was present as well which took the patient back to surgery. (2) Adjacent segment disease after a single level lumbar fusion was a substantial cause of post-surgical issues in a recent report. It commonly signaled the necessity of a reoperation following a thoracolumbar fusion, exposing patients to more post-surgical complications and longer recovery periods. (3) Low back pain patients who underwent fusion surgery had an increased risk of post-surgical work-disability after insurance regulation changes compared with low back pain patients who were treated non-operatively or with decompression alone. (4) In one study, the reoperation for ASD was 25.2% for L4L5 fusion though adjacent segment disease at L5S1 after an L4L5 fusion surgery was minimal. (5) Another study of 1000 patients who experienced back surgery with fusion reported that 9% experienced adjacent segment disease on average at 4.7 years after the first surgery. Adjacent segment disease was most common in degenerative spondylolisthesis at the cranial fusion segment. Risk for adjacent segment disease was increased in patients whose fusions were longer. Adjacent segment disease arose sooner after fusion in elderly patients and in those with degenerative lumbar scoliosis. (6) Chiropractic non-surgical care may meet the call for non-surgical treatment pain after back surgery including fusion back surgery.
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for Augusta chiropractic care of post-surgical continued back pain grows. A study of 32 post-surgical back pain patients treated with Cox® Technic reported improvement of 41% to 57%, higher in those who had combined surgeries like fusions. (7) Another study of Cox® Technic treatment stated that 69 post-surgical continued pain (PSCP) patients received active chiropractic care in the form of Cox® Technic Flexion Distraction for an average of 11 treatments over a 49 day period. Pain relief was 71.6% (SD: 23.2). Twenty four months later, the lasting pain relief was 70% with 32 patients needing further care to keep their pain relief. PSCP patients demonstrated pain relief following specific chiropractic distraction spinal manipulation. (8)
CONTACT Lombardy Chiropractic Clinic
Listen to Dr. Lee Hazen on The Back Doctors Podcast with Dr. Michael Johnson about his care of a failed back surgical syndrome (aka post-surgical continued pain) patient with the Cox® Technic System of Spinal Pain Management.
Schedule your Augusta chiropractic appointment today. Lombardy Chiropractic Clinic cares for post-surgical continued pain and adjacent segment disease. There is no need to suffer the reaction to the action of back surgery when Augusta chiropractic non-operative care is available at Lombardy Chiropractic Clinic.