Failed Back Surgery Syndrome Patients Undergoing Flexion Distraction Chiropractic Treatment: A Case Series

The purpose of this case series is to describe the outcomes of chiropractic therapy using Cox technic flexion distraction decompression spinal manipulation for patients with cervical and lumbar failed back surgery syndrome (FBSS) who were experiencing pain in the areas where they had previously undergone surgery.

This case series includes clinical outcome measures from 61 patients with FBSS treated by 21 certified Cox Doctors of Chiropractic from multiple clinic locations. Primary outcomes were pain severity and function, assessed using Patient-Reported Outcomes Measurement System-29 v1.0, Neck Disability Index, and Numerical Pain Rating Scale (NPRS) questionnaires. Data were analyzed with SPSS software (version 28, IBM Corp). Demographic data were summarized with descriptive statistics. NPRS for neck pain was analyzed using the Friedman test. Repeated measures ANOVA was used to compare initial visit data with data at 3 and 12 months after the onset of care.

The cohort received a mean (SD) of 12.9 (8.0) treatments over 56.3 (35.2) days. Pain relief reported by doctors was 67.2% (28.5%) and by patients was 65.9% (29.3%). Neck Disability Index scores had reduced by 6.4 (SD 6.9) and 2.67 (5.1) at 3 and 12 months, respectively. NPRS showed reduced pain for cervical and lumbar patients at 3 and 12 months. Patient-Reported Outcomes Measurement System-29 v1.0 scores improved in physical function, anxiety, depression, fatigue, pain interference, average pain, spine pain, leg and arm pain, sleep disturbance, and social roles.

Patients with FBSS who received specialized chiropractic flexion distraction spinal manipulation in this study experienced relief of pain and disability.