La Grande Chiropractic Care of Adjacent Segment Disease After Fusion
“For every action there is an equal and opposite reaction.” Just a physics rule? Not at all! It is a truth for many things in life, including back pain and neck pain. Adjacent segment disease exemplifies this theory! When back pain is managed 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 accept the work of the surgical segment which they were not designed to do. These adjacent segments rebel with pain of their own. Dr. Paulette Hugulet, DC, LLC eases 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 reportedly 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 due to a prior fusion. Non-surgical treatment for adjacent segment disease is the first option to try 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 new report. It commonly signaled the need for reoperation following a thoracolumbar fusion, subjecting 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-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 occurred more quickly after fusion in elderly patients and in those with degenerative lumbar scoliosis. (6) Chiropractic non-surgical care may answer the call for non-surgical treatment pain after back surgery including fusion back surgery.
HOW DOES CHIROPRACTIC ADDRESS ADJACENT SEGMENT DISEASE?
Support via research for La Grande chiropractic care of post-surgical continued back pain multiples. A study of 32 post-surgical back pain patients treated 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 in 49 days. Pain relief was 71.6% (SD: 23.2). Two years later, the lasting pain relief was 70% with 32 patients needing further care to keep their pain relief. PSCP patients showed pain relief after specific chiropractic distraction spinal manipulation. (8)
CONTACT Dr. Paulette Hugulet, DC, LLC
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 Management.
Schedule your La Grande chiropractic appointment now. Dr. Paulette Hugulet, DC, LLC 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 La Grande chiropractic non-operative care is available at Dr. Paulette Hugulet, DC, LLC.
