“For every action
there is an equal and opposite reaction.” Just a physics rule? Not at all! It’s a truth for
many things in life, including back pain and neck pain.
Adjacent segment disease shows 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 area. 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 rebel with pain of their own.
Dr. Hoang's 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 supposedly
between 2% and 4% a year according to one study. It contributes to
reoperation rates after spinal fusion. Risks for ASD are many
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 along with adjacent segment disease. Total
disc replacements (TDR) for neck pain conditions using a ball and socket are devised
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 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
signaled the necessity of a reoperation after
a thoracolumbar fusion, exposing patients to more
post-surgical complications and lengthier recovery
periods. (3) Low back pain patients who went through fusion
surgery had an increased risk of post-surgical work-disability
after insurance regulation alterations compared with low back
pain patients who were treated non-surgically 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 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 happened
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
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for Montreal chiropractic care
of post-surgical continued back pain increases. 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 in 49 days. Pain relief was 71.6% (SD: 23.2). Two years
later, the lasting pain
relief was 70% while 32 patients needed further
care to keep their pain relief. PSCP patients demonstrated
pain relief following specific chiropractic distraction spinal
CONTACT Dr. Hoang's 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
Schedule your Montreal chiropractic appointment today.
Dr. Hoang's 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 Montreal chiropractic non-operative
care is available at Dr. Hoang's Chiropractic Clinic.