Explore the intriguing link between spinal manipulative therapy and the likelihood of needing a second surgery after a lumbar discectomy, as we delve into the latest findings from a comprehensive retrospective cohort study.
– by James
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Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study.
Trager et al., BMC Musculoskelet Disord 2024
DOI: 10.1186/s12891-024-07166-x
What’s New: The study investigates the impact of spinal manipulative therapy (SMT) on the likelihood of lumbar spine reoperation in patients with lumbosacral radiculopathy (LSR) following lumbar discectomy. It suggests that SMT may reduce the need for subsequent surgeries.
Importance: This research is significant as it explores a non-surgical intervention that could potentially decrease the need for additional lumbar surgeries, which are often costly and carry risks.
Contribution to Literature: The study contributes to the understanding of alternative postoperative care strategies for lumbar discectomy patients, offering evidence that SMT might be a beneficial treatment option.
Results Summary: After propensity matching for confounding variables, each cohort had 378 patients with a mean age of 61 years. The SMT cohort had a lower reoperation rate (7%) compared to the usual care cohort (13%), with a risk ratio (RR) of 0.55 (95% confidence intervals [CIs]: 0.35-0.85; P = 0.0062). In the SMT group, 72% had at least one follow-up visit, with a median of 6 visits.
Further Considerations: The authors suggest that future prospective studies should include measures of pain, disability, and safety to confirm the relevance of these findings. They also note the possibility that the results may be due to the general effect of engaging with a non-surgical clinician, which could extend to other treatments like physical therapy or acupuncture.
The study is registered on the Open Science Framework (https://osf.io/vgrwz).