New study reveals significant reduction in lumbar spine reoperation with chiropractic spinal manipulation

A new study conducted by researchers at University Hospitals (UH) Connor Whole Health sheds light on the potential benefits of chiropractic spinal manipulation (CSM) for adults experiencing ongoing sciatica following low back surgery. The study, titled “Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study,” was recently published in BMC Musculoskeletal Disorders.

The researchers investigated whether adults receiving CSM for sciatica at least one year after lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving CSM, over a two-year follow-up period.

Using a retrospective cohort study design, the research team analyzed data from a United States network of health records (TriNetX, Inc.) spanning from 2003 to 2023. The authors used a statistical technique called propensity matching to make the chiropractic and usual medical care cohorts similar according to age and other features. The study included a total of 756 patients, with a mean age of 61 years.

The study revealed that patients who received chiropractic spinal manipulation experienced a substantial 45% reduction in the likelihood of undergoing additional lumbar surgery compared to those who received usual medical care. Specifically, the proportion of patients undergoing lumbar spine reoperation was 7% in the chiropractic spinal manipulation group, significantly lower than the 13% in the usual medical care group.

Lead author Robert J Trager, DC, noted, “This is the largest study of its kind to date and shows promise for chiropractic spinal manipulation in this population. However, we need to be careful about interpreting the findings, considering it is an observational study.”

The researchers called for further research to explore the relevance of their findings, with studies that would include measures of pain, disability, and safety. The study also raises questions about the possibility of a generalized effect of engaging with a non-surgical clinician, prompting comparison of the findings to related contexts such as physical therapy or acupuncture.