Question
Hello Dr.

My mother has had multiple surgeries and repeatedly has developed massive scar tissue. She has a history of heart disease. She may have to have surgery to repair a herniated c-3 disk in her spine, that supposedly requires the dr.to go in through her throat. The risk is that scar tissue will form in block the pathway to breathe. What can be done to prevent scar tissue and what other recommendations would you give regarding the surgery procedure?

A concerned daughter,

Marlena

Answer
Hi Marlena,

Make sure you get another opinion regarding neck surgery. As you can imagine, many things go wrong with this surgery. I won't worry you unnecessarily with details unless she is committed. I need to see the MRI results to render judgment on necessity. Most cervical disc herniations and other problems are corrected with towel traction. Flexion/Distraction is also a great option.
If she has to have surgery, follow up with physical therapy that includes therapeutic ultrasound to minimize scar tissue proliferation. Having this type of surgery is definitely last resort material. Even at that, patients usually come out worse after a year. I would do everything possible to avoid it in the first place. Not knowing if you already did this, I can only speculate. Below is a procedure done by some D.C.'s but not all.

Flexion-Distraction Therapy - What is it?


Flexion-Distraction, (F/D) is a gentle, chiropractic treatment procedure utilized for back and neck pain. Flexion-Distraction is a safe alternative to back surgery for those 95% of patients whose conditions do not demand surgical intervention. The doctor is in control of the treatment movements at all times.

Flexion-Distraction is utilized for many conditions such as:

Failed Back surgical Syndromes
Disc Herniation/Ruptured Disc / Bulging Disc / Herniated Disc
Sciatica / Leg pain
"Whiplash" injuries
Stenosis
Arm Pain
Neck Pain
Failed course of Steroid Injections
Chemical Radiculitis
Spondylolisthesis
Headache
Transitional segment
Many more conditions?
How does Flexion-Distraction Work?

For Disc related conditions:

Increases the intervertebral disc height to remove annular tension on the annular fibers and nerve by making more room and improving circulation.
Allows the nucleus pulposus, the center of the disc, to assume its central position within the annular fibers and relieves irritation of the spinal nerve.
Restores vertebral joints to their physiological relationships of motion.
Improves posture and locomotion while relieving pain, improving body functions, and creating a state of well-being.
For Non-Disc related conditions:

Patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac restrictions and misalignment, certain types of spinal stenosis), Flexion/Distraction provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain:

The posterior disc space increases in height.
F/D decreases disc protrusion and reduces stenosis.
Flexion stretches the ligamentum flavum to reduce stenosis.
Flexion opens the vertebral canal by 2 mm (16%) or 3.5 to 6mm more than extension.
Flexion increases metabolite transport into the disc.
Flexion opens the apophyseal joints and reduces posterior disc stress
The nucleus pulposus does not move on flexion. Intradiscal pressure drops under distraction to below 100mm Hg. On extension the nucleus or annulus is seen to protrude posterior into the vertebral canal.
Intervertebral foraminal openings enlarge giving patency to the nerve.

Reference: Cox JM, Feller JA, Cox-Cid JA: Topics in clinical Chiropractic 1996; 3(3):45-59


If you need help finding a competent physician for a second or even a third opinion, please don't hesitate to ask, the risk is just too high.

Please get back to me with the MRI report, then I will have a much better idea what she is up against.

Dr. Timothy Durnin
drs.chiroweb.com