Abstract
BackgroundA brief overview of failed back surgery syndrome, with emphasis on low back pain status post spinal cord stimulation, and post-surgical spinal manipulation is presented.Case PresentationFour cases of patients within the VA Connecticut Health Care System presenting between July 2014 and July 2015 reporting low back pain after surgical insertion of spinal cord stimulators are discussed. This study describes the outcomes experienced by four patients with low back pain status post implanted spinal cord stimulators receiving manual therapy in the form of lumbar spine manipulation or mobilization.ConclusionAll four patients denied adverse effects to spinal manipulation/mobilization and onset of new symptoms after treatment; two patients reported durable reduction in low back pain with increased tolerance to walking, standing, or lying down, one reported temporary relief of low back pain, and one reported no change in symptoms. Further investigation is needed to determine the benefit of spinal manipulation in patients with implanted spinal cord stimulators, but this study has shown the absence of adverse effects from manipulation or mobilization treatment, in regards to SCS.
Highlights
A brief overview of failed back surgery syndrome, with emphasis on low back pain status post spinal cord stimulation, and post-surgical spinal manipulation is presented.Case Presentation: Four cases of patients within the VA Connecticut Health Care System presenting between July 2014 and July 2015 reporting low back pain after surgical insertion of spinal cord stimulators are discussed
The main objective of this study is to describe the potential adverse effects of lumbar spine manipulation in post-surgical patients with spinal cord stimulators; the cases presented were drawn from patients presenting at the VA Connecticut Healthcare System
Four patients with chronic low back pain status post spinal cord stimulator implantation were treated with manual therapy; of these patients, two were treated with
Summary
Four patients with chronic low back pain status post spinal cord stimulator implantation were treated with manual therapy; of these patients, two were treated with. Spinal manipulation and/or mobilization has been shown to be a safe and effective treatment for the treatment of chronic low back pain [14,15,16]. Cases studies have been performed that address the safety and efficacy of chiropractic care in post-surgical spinal pain [19, 21, 28,29,30,31,32,33,34,35], and no investigation has been done in regards to spinal manipulation as a treatment for chronic low back pain in patients with implanted spinal cord stimulators. In patients with continued low back pain after implantation of a spinal cord stimulator, where further spinal surgeries or pharmacological treatment are not indicated, spinal manipulation and/or mobilization may be considered. DeBakey VA Medical Center, Rehabilitation Care Line, 580/RECL 117, 2002 Holcombe Boulevard, Houston, TX 77030, USA. 2VA Connecticut Healthcare System, Physical Medicine and Rehabilitation, 950 Campbell Ave, West Haven, CT 06516, USA
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