“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 neck and back pain.
Adjacent segment disease exemplifies this principle!
When back pain is managed 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 segment. These are the adjacent segments. These segments accept the work of the surgical segment which they were not created
to do. These adjacent segments rebel with pain of their own.
Johnson Chiropractic soothes these rebellious adjacent segments with
gentle, non-operative, 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 supposedly
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 due to
a previous 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 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 replicate normal motions
of the cervical spine. In a surgery for adjacent segment disease in a patient
with a TDR, fusion was seen, yet 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 significant
cause of post-surgical issues in a new report. It generally
signaled the necessity of a reoperation following
a thoracolumbar fusion, subjecting patients to more
post-surgical complications and lengthier recovery
periods. (3) Low back pain patients who underwent 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-surgically 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 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 frequent 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
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 Richmond chiropractic care
of post-surgical continued back pain grows. A study
of 32 post-surgical back pain patients cared for with Cox®
Technic reported improvement of 41% to 57%, greater
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 via Cox® Technic Flexion Distraction for an average of 11
treatments over in 49 days. Pain relief was 71.6% (SD: 23.2). Two years
later, the continued 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
CONTACT Johnson Chiropractic
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 Richmond chiropractic appointment today.
Johnson Chiropractic 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 Richmond chiropractic non-operative
care is available at Johnson Chiropractic.