Question
My dad is 72 years old. He had back surgery about q yr ago where they fused part of his spine. The degeneration is progressively getting worse effecting more of the spine. He is severely hunched over..not in alot of pain but can not stand up straight. He asked today if we could get a second opinion...what do you suggest. We are in upstate NY

Answer
Hi Stephanie,

First and foremost, your father should have had post operative care that includes the following.

Physical Therapy to prevent range of motion degradation.

Therapeutic Ultrasound 3x/wk for 3 months to minimize scar tissue proliferation.

Manual manipulation or spinal decompression therapy  which includes flexion/distraction.

Nutritional support to include glucosamine sulfate with MSM to prevent osteoarthritis.

If the surgeon is typical, he did a "cut and run" and left your father to fend for himself. Most people today need overwhelming evidence of medical necessity to have lumbar surgery. Since over 90% are done unnecessarily and most if not all end up with poor clinical outcomes, the insurance industry has undergone radical policy change. The AHA (American Hospital Association) has made it clear that they will not endorse these procedures unless the patient has continence (loss of bowel and/or bladder control) issues.

Your father should see a D.C. that has F/D tables as soon as possible. Not all D.C.'s can afford this equipment, so call around until you locate one. If you fail to find someone that deals with post surgical lumbar problems, I will personally find you someone that can.

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

I hope that your father wasn't put under the knife because he had a herniated disc. I hope it was a plausible diagnosis that included nerve entrapment by something else. If it was a disc, most are, he didn't need surgery. F/D permanently decompresses disc lesions in all but a few instances. Most likely your father had a foraminostomy, this enlarges the opening for the nerve roots. It is necessary if it is obstructed by arthritic spur formation.

Either way, at this point he should see a good Chiropractor for follow up. Many people think that after back surgery, Chiropractic is out of the question. I believe some think this because Chiropractic is associated with "cracking Bones". This of course is not always the case. Many Centurions, osteoporotic and fragile people see D.C.'s on a regular basis without issue. You just have to have the correct type of table.

Follow my protocols listed above or bring them to the next physician you see. You can always call me if you need specific information.

Hope this helps.

Dr. Timothy Durnin
drs.chiroweb.com