Case Reports| Volume 34, ISSUE 6, P408-412, July 2011

Download started.


Chiropractic Management of Postsurgical Lumbar Spine Pain: A Retrospective Study of 32 Cases



      Although chiropractic manipulation is commonly used for low back pain, applying this procedure to the patient with postlumbar 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.


      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 posttreatment pain measures using the Numeric Pain Scale (NPS) that ranged from 0 (no pain) to 10 (worst pain imaginable).


      A change was observed in the mean pretreatment and posttreatment 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.


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

      Key Indexing Terms

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Manipulative & Physiological Therapeutics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Martin BI
        • Mirza SK
        • Comstock BA
        • Gray DT
        • Kreuter W
        • Deyo RA
        Reoperation rates following lumbar spine surgery and the influence of spinal fusion procedures.
        Spine. 2007; 32: 382-387
        • Weinstein JN
        • Lurie JD
        • Olson PR
        • Bronner KK
        • Fisher ES
        United States' trends and regional variations in lumbar spine surgery: 1992-2003.
        Spine (Phila Pa 1976). 2006; 31: 2707-2714
        • Mekhail N
        • Wentzel DL
        • Freeman R
        • Quadri H
        Counting the costs: case management implications of spinal cord stimulation treatment for failed back surgery syndrome.
        Prof Case Manag. 2011; 16: 27-36
        • McMorland G
        • Suter E
        • Casha S
        • du Plessis SJ
        • Hurlbert RJ
        Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study.
        J Manipulative Physiol Ther. 2010; 33: 576-584
        • Cramer GD
        • Henderson CN
        • Little JW
        • Daley C
        • Grieve TJ
        Zygapophyseal joint adhesions after induced hypomobility.
        J Manipulative Physiol Ther. 2010; 33: 508-518
        • Gluck NI
        Passive care and active rehabilitation in a patient with failed back surgery syndrome.
        J Manipulative Physiol Ther. 1996; 19: 41-47
        • Estadt GM
        Chiropractic. Rehabilitative management of post-surgical disc herniation: a retrospective case report.
        J Chiropr Med. 2004; 3: 108-115
        • O'Shaughnessy J
        • Drolet M
        • Roy JF
        • Descarreaux M
        Chiropractic management of patients post-disc arthroplasty: eight case reports.
        Chiropr Osteopat. 2010; 18: 7
        • Kruse R
        • Cambron JA
        Cox decompression chiropractic manipulation of a patient with post-surgical lumbar fusion: a case report.
        J Chiropr Med. 2011; (in press)