Breaking down the new BMC Musculoskeletal Disorders study  

Researchers at University Hospitals (UH) Connor Whole Health have found chiropractic spinal manipulation therapy (SMT) might reduce the need for reoperation in adults with ongoing sciatica post-lower back surgery.

Published in BMC Musculoskeletal Disorders, the study compared patients receiving SMT at least one year after lumbar discectomy to those receiving usual care without SMT. Results showed the SMT cohort had a lower incidence of reoperation, suggesting potential cost savings and highlighting a trend of patients seeking chiropractic care for lower back pain. Lead author Robert J. Trager, DC, advises cautious interpretation and calls for further research on SMT’s long-term benefits. 

This article explores the key findings of this study, explains what DCs like you should be aware of and provides context for how you can apply these findings to your own practice.  

Exploring the BMC Musculoskeletal Disorders study

In the study, researchers provide context for the purpose of their research.  

According to the study, patients who undergo lumbar discectomy are likely to experience ongoing lumbosacral radiculopathy (LSR).  

Ultimately, they state, this leads them to seek spinal manipulative therapy in order to manage their symptoms.  

The purpose of this study was to prove that patients who receive SMT at least one year following their LSR are less likely to need reoperation.  

More specifically, researchers say in the study, “We hypothesized that adults receiving SMT for LSR at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up.”   

To prove this, researchers scoured the network of health records for patients aged over 18 with LSR and lumbar discectomy less than one year previously. Conditions included patients who did not have lumbar fusion or instrumentation.  

The researchers then divided these patients into the following two cohorts:  

1. Chiropractic SMT  
2. Usual care without chiropractic SMT  

With a few factors in mind, like propensity matching to adjust for confounding variables, such as body mass index or nicotine dependence, they explored the cumulative incidence of reoperation against the number of SMT follow-up visits.  

The results and conclusion of the BMC Musculoskeletal Disorders study

Researchers found there were 378 patients per cohort. Of those cohorts, lumbar spine reoperation was less frequent in the SMT cohort than in the usual care cohort.  

Ultimately, their research findings suggest that adults who experienced LSR at least one year after their lumbar discectomy who received SMT were less likely to undergo reoperation compared to those who did not receive SMT.  

How this applies to chiropractic care

Though the lead author of the study, Robert J. Trager, DC, stated DCs should be careful in how they interpret the findings of this study, he also noted it showed promise for chiropractic spinal manipulation in this population.  

What the BMC Musculoskeletal Disorders study means to DCs

This study:

• Could act as anecdotal evidence that people are turning toward DCs for lower back pain care. 
• Provides observable evidence that patients who did not need lumbar spine operations in the SMT cohort could have significant cost savings, though the study does not directly measure costs. 
• Could likely lead to further studies about how SMT can prevent reoperations and potentially provide extended healing benefits. 

Final thoughts

While further research is necessary, especially in the areas of cost savings and long-term benefits, this study has demonstrated that spinal manipulation therapy has promise as an intervention for back pain in patients who want to avoid a second surgical procedure. 

For more news from the chiropractic world, especially the latest and most relevant chiropractic studies that discerning DCs should dissect and evaluate, remember to subscribe to Chiropractic Economics magazine.