This topic contains 4 replies, has 4 voices, and was last updated by 
Eric Lambert, DC February 28, 2019 at 8:08 am.
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Eric Lambert, DC
I have a patient, 39 year old male, who had an L4-L5 laminectomy 8 weeks ago come into my office this week from his medical provider. The same area re-herniated again post surgery with in the last few weeks Documented L4-L5 disc “re-herniation” and L5-S1 disc bulge on MRI taken just last week.
His surgeon wants to do surgery again, but he has no neurological issues or weakness in his legs, just left glute tightness and left glute pain with sitting anymore than a few minutes.
He is loaded with scar tissue in his lumbar spine. He also has some inflammation still at the left L4 area, mainly on the left, where the scar of incision is. This is causing his left glute to have a lot of protective tension.
My question is, Does anyone have experience with how soon you could use IAR on the lumbar spine with 8 weeks post surgery. He could really use some treatment to his lower back. He does not want to go back under the knife, at least not with his last surgeon
Thanks for the help.
Carl Nottoli, DC
If he can tolerate the motions of treatment he should be fine if conservative care is going to work. I wouldn’t stress about treating directly on the scar or not. Use your judgement. When you want to test it do it lightly for a couple passes and see what happens. But you may need to treat other areas first to let that area heal a bit more.
Tim Edwards
For what it is worth… After I had a mole cut out, the surgeon said the scar will be weak and can possibly pull open at least until 3 months post surgery. Big cut in the middle of my back. He was concerned with aesthetics as well as healing. Regardless I ended up with a big keloid scar.
Eric Lambert, DC
Thanks for the answers. I tried IAR on his lower back today, lightly, but changed him from 50% to 80%, which was nice. He felt looser immediately. I’ll have to wait a week to figure out how he does, as he was leaving for a business trip later today. Thanks again for the help. I’ll repost how he is after I see him next.
Eric Lambert, DC
Update on my fresh laminectomy patient. He is responding well, but slowly to light IAR treatment. Yesterday he told me that he felt like he could get up faster and go up the stairs faster, which was an improvement. He’s also been able to sustain at 70% QLF since his first visit. I’m tempted to try some light MAR to his erectors as well, since he’s about 12 weeks post surgical now. Any other thoughts are welcome. Thanks for the help guys.
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