“For every action there is an equal and opposite reaction.” A physics rule only? Not at all! It applies to many things in life, including neck and back pain. Adjacent segment disease exemplifies this theory! When back pain is managed with back surgery, especially 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 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. New Hampshire Spine and Sport eases these rebellious adjacent segments with gentle, non-surgical, 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 diverse including existing degeneration of adjacent segments, predisposition to degenerative changes, and altered biomechanical forces because of an earlier fusion. Non-surgical treatment for adjacent segment disease is the first option to try as long as progressive neurological deficit is not a problem. (1)
HOW DOES BACK SURGERY INFLUENCE ADJACENT SEGMENT DISEASE RISK?
Types of surgical approaches have an effect on 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 replicate 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 generally signaled the need for reoperation following a thoracolumbar fusion, subjecting patients to more post-surgical complications 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 alterations 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 underwent a fusion back surgery 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 happened 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 back surgery with fusion.
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for Southern New Hampshire chiropractic care of post-surgical continued back pain multiples. A study of 32 post-surgical back pain patients treated with Cox® Technic showed improvement of 41% to 57%, higher 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 showed pain relief following specific chiropractic distraction spinal manipulation. (8)
CONTACT New Hampshire Spine and Sport
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 Southern New Hampshire chiropractic appointment today. New Hampshire Spine and Sport 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 Southern New Hampshire chiropractic non-operative care is available at New Hampshire Spine and Sport.