Presented at The ACC/RAC International Research Conference 2012
Pfefer, M, Cooper,S and Morris,R
Patients that continue to experience chronic, disabling back pain one or more years following spinal surgery are said to have failed back surgery syndrome (FBSS). The incidence appears to be between 10 and 50% of all back surgeries.
Sufferers often experience intractable pain, work disability, impaired physical functioning, insomnia, and decreased quality of life (4-6).
Typical, current treatments offer limited benefit and inherent risk. Revision spinal surgery is a common remedial therapy, however with varying results (2,13,14). Other treatments include continuous intrathecal drug delivery (5,15), spinal cord stimulation (16-18), pulsed radiofrequency (19), epidural steroids (20, 21), and psychosocial therapies (22).
The Morris Spinal Stenosis and Disc Center developed a very comprehensive and precise program that included non-surgical spinal decompression, chiropractic, physical therapy, home, gym rehabilitation and occupational therapy.
The Typical Patient Included in The Study:
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Number of Patients Studied With Failed Low Back Surgeries: 31
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Median Age: 60
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58% were told they needed another surgery before treating here
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58% failed prior chiropractic treatment
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65% failed prior physical therapy treatment
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68% failed epidural injections
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26% failed acupuncture
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Mean number of years the patient had mild or moderate pain in that area: 15.6
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Mean number of months the patient had severe pain: 16
The Results of Treatment Were As Follows:
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The % decrease in daily pain medication: 69%
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The % decrease in daily narcotic use: 63%
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Mean low back pain improved: 66% (VAS 7.2 to 3.2 out of 10)
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Mean leg pain improved: 52% (VAS 8.2 to 3.9 out of 10)
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% of areas with decreased sensation that returned to normal following treatment: 38%
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% of areas with decreased muscle strength that returned to normal following treatment: 78%
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% of abnormal deep tendon reflexes that returned to normal following treatment: 50%
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The ability to stand in minutes increased by: 100%.
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The ability to walk in miles increased by: 211%
Given the extreme morbidity and difficulty in treating these patients, the results were unusually good in all areas measured and without complications. Future studies are warranted with larger numbers of patients and in other fascilities to see if these results can be replicated.