“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 back pain and neck pain.
Adjacent segment disease illustrates this principle!
When back pain is addressed with back surgery, especially
back surgery needing 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 designed
to do. These adjacent segments rebel with pain of their own.
Soft Health and Healing Clinic eases these rebellious adjacent segments with
gentle, non-surgical, pain-relieving chiropractic treatment.
WHAT IS ADJACENT SEGMENT DISEASE?
Researchers explain 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 assorted
including existing degeneration of adjacent segments, predisposition to degenerative
changes, and changed biomechanical forces due to
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 designed
to preserve motion and reproduce normal motions
of the cervical spine. In a surgery for adjacent segment disease in a patient
with a TDR, fusion was noted, 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 substantial
cause of post-surgical issues in a new report. It commonly
indicated the necessity of a reoperation after
a thoracolumbar fusion, exposing patients to more
post-surgical complications and longer 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 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 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 arose
sooner after fusion in elderly patients and in those with degenerative
lumbar scoliosis. (6) Chiropractic non-surgical care may meet the plea
for non-operative treatment pain after back surgery including fusion
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for Brooks chiropractic care
of post-surgical continued back pain increases. 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 reported 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). Two years
later, the continued pain
relief was 70% with 32 patients needing further
care to maintain pain relief. PSCP patients demonstrated
pain relief following specific chiropractic distraction spinal
CONTACT Soft Health and Healing Clinic
Listen to Dr.
Lee Hazen on The Back Doctors
Podcast with Dr. Michael Johnson about his treatment of a failed
back surgical syndrome (aka post-surgical continued pain) patient with the Cox®
Technic System of Spinal Pain
Schedule your Brooks chiropractic appointment now.
Soft Health and Healing 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 Brooks chiropractic non-operative
care is available at Soft Health and Healing Clinic.