“For every action
there is an equal and opposite reaction.” Just a physics rule? No! It is a truth for
many things in life, including back pain and neck pain.
Adjacent segment disease exemplifies this principle!
When back pain is addressed with back surgery, particularly
back surgery including a spinal fusion, the reaction to
the action of the fusion is pressure on the spinal segments above and below the
surgical segment. These are the adjacent segments. These segments take
over the work of the surgical segment which they were not created
to do. These adjacent segments protest with pain of their own.
Spinal Care Clinic soothes these rebellious adjacent segments with
gentle, non-operative, pain-relieving chiropractic treatment.
WHAT IS ADJACENT SEGMENT DISEASE?
Researchers describe adjacent segment
disease (ASD) as a “disappointing long-term outcome for both the patient and
clinician.” Cervical and lumbar spine adjacent segment disease is supposedly
between 2% and 4% a year according to one study. It impacts
reoperation rates after spinal fusion. Risks for ASD are many
including existing degeneration of adjacent segments, predisposition to degenerative
changes, and changed 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 an issue. (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 created
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 too which took the patient back to surgery. (2) Adjacent
segment disease after a single level lumbar fusion was a significant
cause of post-surgical issues in a recent report. It commonly
indicated the necessity of a reoperation following
a thoracolumbar fusion, exposing patients to more
post-surgical issues and lengthier recovery
periods. (3) Low back pain patients who went through fusion
surgery had an elevated risk of post-surgical work-disability
after insurance regulation changes compared with low back
pain patients who were treated non-operatively or with
decompression only. (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 low. (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 elevated in patients whose fusions were longer. Adjacent segment disease occurred
more quickly after fusion in elderly patients and in those with degenerative
lumbar scoliosis. (6) Chiropractic non-surgical care may answer the plea
for non-surgical treatment pain after back surgery including fusion
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for Burlington and Hamilton chiropractic care
of post-surgical continued back pain grows. A study
of 32 post-surgical back pain patients cared for with Cox®
Technic showed improvement of 41% to 57%, greater
in those who had combined surgeries like fusions. (7) Another study of Cox®
Technic treatment reported that 69 post-surgical continued pain
(PSCP) patients experienced 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). Two years
later, the lasting pain
relief was 70% while 32 patients needed further
care to maintain pain relief. PSCP patients demonstrated
pain relief following specific chiropractic distraction spinal
CONTACT Spinal Care 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
Schedule your Burlington and Hamilton chiropractic appointment today.
Spinal Care Clinic cares for post-surgical continued pain and adjacent segment
disease. It’s not necessary to suffer the reaction to
the action of back surgery when Burlington and Hamilton chiropractic non-operative
care is available at Spinal Care Clinic.