Lumbar diskectomy is a surgical procedure for removing herniated intervertebral disk material when non-surgical options fail to satisfactorily alleviate radiating leg pain, numbness, or weakness. However, there’s no guarantee such a procedure will provide relief. Up to 12% of patients require reoperation withing three months to address post-surgical complications and up to 20% may experience continued or recurrent radiculopathy symptoms a year later. The term failed back surgery syndrome is often applied to those having more than one operation and unfortunately, studies show spinal reoperations generally have a lower success rate than the initial procedure. Furthermore, there is no consensus or agreement on the most appropriate care strategy for this patient population.
A 2023 study that retrospectively examined a decade of medical records concerning 110 million Americans found that 10.8% of those who had received chiropractic treatment for a spinal condition had a previous history of spine surgery. Treatment guidelines for low back conditions generally recommend non-surgical treatment as a front-line approach, of which chiropractic care has proven to be an excellent choice. While case studies have reported improvements in pain and disability associated with chiropractic care for the post-back surgery population, there hasn’t been much research on whether such treatment can reduce the risk for reoperation.
To find out, a group of researchers reviewed two decades of data concerning more than 114 million patients attending 80 academic medical centers, affiliated hospitals, and outpatient offices. From this data set, they extracted 756 patients who had undergone lumbar diskectomy and experienced ongoing radiculopathy symptoms, half of whom had been treated with spinal manipulative therapy, the primary treatment provided by doctors of chiropractic. The research team found that those who received spinal manipulative therapy (the median being six treatments) were nearly half as likely to undergo an additional procedure in the following year (7% vs 13%).
While additional studies are needed before treatment guidelines for the post-surgical radiculopathy patient can be established and implemented, the data suggest that the population of patients who don’t respond to lumbar diskectomy could benefit from a short-term course of chiropractic care.
