Characteristics of Individuals Undergoing Chiropractic Spinal Manipulative Therapy with a History of Spine Surgery: A Descriptive Retrospective Cohort Study

Introduction: Previous studies have suggested Chiropractic spinal manipulative therapy (CSMT) can be an effective therapy for treating individuals with low back and neck pain. However, the population of patients receiving CSMT with a previous history of spine surgery has not been previously described or studied in isolation.

Methods: TriNetX, a globally federated research network, was used to identify individuals who received CSMT following a previous spine surgery.117,000 individuals were identified as receiving CSMT from 2003 to 2022, and 12,711 patients were distinguished as having at least one prior spine surgery. Demographics, history of spinal surgery, and other treatment modalities utilized by individuals receiving CSMT with a history of spine surgery were reported.

Results: A considerable portion of patients receiving CSMT had a history of spinal surgery (10.9%). Compared to the general CSMT cohort, the CSMT + previous spine surgery cohort was significantly older, more white, female, and overweight (p < 0.0001). A vast majority of patients in this cohort had a history of spinal fusion surgery (11,329, 89%) and significantly increased rates of low back pain (11,568, 91%) and cervicalgia (8,991, 71%) compared to the general CSMT cohort (p < 0.0001). Additionally, opioids, antidepressants, muscle relaxants, spinal injections, manual therapy, traction, and other treatment options were significantly more common in the CSMT + spine surgery cohort (p < 0.0001).

Conclusion : This is the first large-scale study detailing the characteristics of patients receiving CSMT after spine surgery. Our study shows that the demographics of the CSMT + prior spine surgery cohort are significantly different than the general CSMT cohort. Moreover, these patients utilize higher rates of pharmaceutical and alternative therapeutic treatments. Based on our findings, future studies are needed to validate the safety and efficacy of CSMT in patients with prior spine surgery as this population significantly differs from the general population receiving CSMT.