Wednesday, September 14, 2011

Chiropractic Management Of Postsurgical Lumbar Spine Pain

Kruse, RA; Cambron, J: Chiropractic Management Of Postsurgical Lumbar Spine Pain: A Retrospective Study Of 32 Cases. Journal Of Manipulative And Physiological Therapeutics 2011;34(6):408‐412

Objective: Although chiropractic manipulation is commonly used for low back pain, applying this procedure to the patient with post lumbar spine surgery has not been adequately studied.

The purpose of this retrospective chart review is to report on the results of chiropractic management (including Cox flexion distraction technique) of patients with postsurgical lumbar spine pain to determine the change in reported pain based on surgical type.

Methods: Ten years of patient files from one chiropractic practice were electronically screened for lumbar spine surgery occurring before presenting for chiropractic care. Of the 58 patients with a postsurgical diagnosis, 32 files contained all pertinent components for this study including treatment with Cox flexion distraction manipulation (in addition to adjunct procedures) for at least 2 weeks and pretreatment and post‐treatment pain measures using the Numeric Pain Scale (NPS) that ranged from 0 (no pain) to 10 (worst pain imaginable).

Results: A change was observed in the mean pretreatment and post‐treatment NPS pain scores of 6.4 to 2.3, a reduction of 4.1 of 10. The mean number of treatments was 14, with a range of 6 to 31. When stratified by surgical type, the mean change in pain was most remarkable in patients who underwent a surgery that combined lumbar discectomy, fusion, and/or laminectomy, with an average NPS pain reduction of 5.7 of 10. No adverse events were reported for any of these postsurgical patients.

Conclusions: The results of this study showed improvement for patients with low back pain subsequent to lumbar spine surgery who were managed with chiropractic care.


32 CASES OF POST SURGICAL CONTINUED PAIN WERE TREATED WITH COX FLEXION DISTRACTION MANIPULATION (IN ADDITION TO ADJUNCT PROCEDURES) FOR AT LEAST 2 WEEKS. PRETREATMENT AND POST TREATMENT PAIN MEASURES USING THE NUMERIC PAIN SCALE (NPS) SHOWED A REDUCTION OF 4.1 OF 10 NPS VALUES WITH A MEAN NUMBER OF 14 TREATMENTS. THE RESULTS OF THIS STUDY SHOWED IMPROVEMENT FOR PATIENTS WITH LOW BACK PAIN SUBSEQUENT TO LUMBAR SPINE SURGERY WHO WERE MANAGED WITH COX FLEXION DISTRACTION CHIROPRACTIC CARE

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