Georgetown Chiropractic Care of Adjacent Segment Disease After Fusion

October 04, 2019

“For every action there is an equal and opposite reaction.” A physics rule only? Nope! It is a truth for many things in life, including back pain and neck pain. Adjacent segment disease shows this theory! When back pain is addressed with back surgery, particularly back surgery involving 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 accept the work of the surgical segment which they were not designed to do. These adjacent segments protest with pain of their own. Dr. Butwell eases these rebellious adjacent segments with gentle, non-surgical, pain-relieving chiropractic treatment.


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 reportedly between 2% and 4% a year according to one study. It influences 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 an earlier 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)


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 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 seen, but adjacent segment disease was present as well 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 necessity of a reoperation after a thoracolumbar fusion, subjecting patients to more post-surgical complications 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 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 low. (5) Another study of 1000 patients who underwent back surgery with fusion 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 elevated in patients whose fusions were longer. Adjacent segment disease occurred sooner after fusion in elderly patients and in those with degenerative lumbar scoliosis. (6) Chiropractic non-surgical care may meet the call for non-surgical treatment pain after back surgery including fusion back surgery.


Support via research for Georgetown 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%, 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 experienced 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 continued pain relief was 70% while 32 patients needed further care to keep their pain relief. PSCP patients demonstrated pain relief following specific chiropractic distraction spinal manipulation. (8)

CONTACT Dr. Butwell

Listen to Dr. Lee Hazen on The Back Doctors Podcast with Dr. Michael Johnson about his care of a failed back surgical syndrome (aka post-surgical continued pain) patient with the Cox® Technic System of Spinal Pain Management.

Schedule your Georgetown chiropractic appointment today. Dr. Butwell cares for post-surgical continued pain and adjacent segment disease. There is no need to suffer the reaction to the action of back surgery when Georgetown chiropractic non-operative care is available at Dr. Butwell.

Dr. Butwell offers relieving care non-surgically to back pain patients suffering with adjacent level pain after spinal fusion surgery.