Every year in the U.S. alone, LBP (Low Back Pain) accounts for more than three million visits. Ideally, it affects around 84-percent of the general population in the whole world. And going by these facts, everyone is expected to have LBP that needs treatment! The evidence dating back to the early Greek and Roman eras indicate that back pain was very prevalent, and the bad news is; this hasn’t changed a bit. Some people feel the prevalence of back pain among humans is due to the fact that we walk on two legs (bipedal) rather than four (quadrupedal). When you compare degenerative disk disease to spinal osteoarthritis, you realize that four-legged species postponed the two by around a couple of decades. But, no matter the reason, back pain is the rule, including when it comes to patient visits to medical doctors and chiropractors. The last time we looked at the surgical rate of LBP by comparing patients who first went to surgeons vs. those who first went to chiropractors, we were surprised by the findings! It is important to note that around 43-percent of workers who initially visited a surgeon had a surgery compared to just 1.5-percent of those who first visited a chiropractor! Therefore, questions we have this month are how successful is spinal surgery and what of all those patients, who despite having surgery, still experience issues; can chiropractors still help them?
A review of the literature published in the Journal of the American Academy of Orthopedic Surgeons indicated that most cases of DDD (degenerative disk diseases) require non-surgical approaches like chiropractic care. According to the review, success rate of spinal fusions for DDD is just 50 – 60%. The advent of artificial disk (which initially proposed to be cure for symptomatic disk disease) has not fared well, considering the possible worse long-term issues, which are yet to be understood. According to the authors of the review, surgery should be the last option despite patients viewing it as a cure-all and ready to embrace it. Surgeons should also consider the list of contradiction and only recommend surgery for those patients who truly need it. Ideally, another study points out that artificial disk surgery among 40-percent of patients failed after 10 years and the patients had to undergo a second surgery in a span of 3 years! Similar findings are also common in post-surgical spinal stenosis and other spinal conditions.
Therefore, what about the success rate for patients who have undergone low back surgery? In an article published in 2012, 3 patients with prior lumbar spinal fusions at least 2 years before were first treated with spinal manipulation (that is 3 treatments over 3 consecutive days) and then underwent rehabilitation for 8 weeks. Upon the completion of care, it was noted that all the 3 patients (100-percent) had clinical improvement, which were still maintained one year later. Another study reported that 32 cases of patients who had post-surgical low back pain underwent for chiropractic care, and this led to an average drop in pain from 6.4/10 – 2.3/10 (that implies pain was reduced by 4.1/10, which is basically 64-percent). Ideally, a larger drop was noted upon dividing up patients who underwent a combination of spinal surgeries (laminectomy, fusion, and/or diskectomy). They had a pain drop of 5.1/10!
Surgeons should turn to spinal surgery if they have no option at all; however, we now know it’s impossible. A patient who has had more than one surgery but still has pain, the term failed backed syndrome is applied and carries many disability and symptoms. Again, we should use chiropractic pre-surgically and post-surgically if we want the best results.