By Gary D. Dillon, DC –
The January 10, 2009 issue of the Journal of Vertebral Subluxation Research reports on a case involving a 58 year-old man with failed back surgery syndrome who experienced significant improvements after a short course of chiropractic care.
Failed back surgery syndrome has been defined as “the post surgical patient’s experiencing considerable pain, having compromised neurological status, requiring the same dosage of pain medication, being unable to return to work and reporting an unimproved activity level.”
The factors that contribute to the syndrome include incorrect diagnosis, incorrect indication for surgery and surgical complications as well as psychological distress of the patient. According to researchers, the condition is relatively common because up to 2/3 of back surgeries were deemed unnecessary.
In this study, the patient originally hurt his back at work and experienced pain down his right leg as a result. He tried chiropractic care at that time and had no success. At that time, surgery was recommended.
After L5/S1 laminectomy surgery, his pain was worse and he was now experiencing back pain as well as the leg pain. He had been an installer of sheet metal products for 25 years and since the surgery made him worse and he was now unable to perform his work duties, he claimed disability.
Three years after the surgery, the patient decided to try chiropractic again since the pain now was radiating down the left leg into the foot. He experienced the pain more after activity such as standing or walking. A chiropractic examination was performed, along with quality of life questionnaires that were used to monitor improvement in the patient’s condition.
Chiropractic care was started and after 32 visits over 5 weeks, a reevaluation was performed. On the Visual Analog Scale for pain, he improved from an 8 before care began to a 2 at the end of the study period (10 is worst, 1 is best). His SF-36 quality of life survey revealed an improvement in the mental component summary scale. Before chiropractic care he measured 44 on a scale of 100 (100 being best). Upon reevaluation, he had improved to a high of 62. He also showed significant improvement in his posture as well as his low back range of motion, both indicators of spinal health.
After the initial reporting period of the study ended, the patient remains under chiropractic care on a wellness basis and continues to experience improvement. According to the author, “he enjoys increased mental function, no leg pain, diminished back pain, better posture and an overall better quality of life.”
Commentary: As common as failed back surgery syndrome is, we are happy to see that the devastating effects don’t necessarily need to be permanent. We are also happy to see that this patient tried chiropractic care again after initial attempts were unsuccessful. Differences in technique, duration of care and other factors were likely involved.