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Manahawkin 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 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 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. Manahawkin Chiropractic Center eases these rebellious adjacent segments with gentle, non-operative, pain-relieving chiropractic treatment.


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 reportedly 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 changed 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)


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 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 signaled the need for reoperation after a thoracolumbar fusion, subjecting patients to more post-surgical complications and longer 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-operatively 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 common 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 sooner after fusion in elderly patients and in those with degenerative lumbar scoliosis. (6) Chiropractic non-surgical care may answer the call for non-operative treatment pain after back surgery including fusion back surgery.


Support via research for Manahawkin chiropractic care of post-surgical continued back pain multiples. A study of 32 post-surgical back pain patients cared for 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 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). Twenty four months later, the lasting pain relief was 70% while 32 patients needed further care to keep their pain relief. PSCP patients showed pain relief following specific chiropractic distraction spinal manipulation. (8)

CONTACT Manahawkin Chiropractic Center

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 Manahawkin chiropractic appointment today. Manahawkin Chiropractic Center 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 Manahawkin chiropractic non-operative care is available at Manahawkin Chiropractic Center.

Manahawkin Chiropractic Center offers relieving care non-surgically to back pain patients experiencing adjacent level pain after spinal fusion surgery. 
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