@rxgutuerrez: #CapCut upside down 変身

RxGutuerrez

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Wednesday 21 October 2026 10:17:29 GMT

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#stitch with @Dr. James Ferraro If you have a spinal fusion, this is something I REALLY want you to understand before someone tells you that the segments next to your fusion “need to be manipulated.” A fusion eliminates motion at one spinal segment. That changes how motion and load are distributed throughout the rest of the spine, the adjacent-segment phenomenon. Biomechanical research has demonstrated increased motion and intradiscal pressure at the levels next to a cervical fusion. In one cadaveric study, intradiscal pressure increased 73% above the fusion and 45% below it during flexion. And this isn't just something we see in a laboratory. Hilibrand et al. reported symptomatic adjacent-segment disease occurring at approximately 2.9% per year, with an estimated 25% of patients developing symptomatic adjacent-segment disease within 10 years following cervical arthrodesis. Now here's where the logic gets ridiculous: “This segment is already taking on additional motion and mechanical demand…therefore I'm going to forcibly manipulate it because it needs more motion.” That's not an explanation of biomechanics. That's a contradiction. Adjacent-segment disease is multifactorial, and the evidence specifically examining manual therapy after cervical fusion is limited. A 2022 scoping review found only 12 relevant studies, with most being case reports, and concluded that there is insufficient high-quality evidence to establish the safety or clinical utility of manual therapy after cervical surgery. So no, I'm not saying every manual technique around every fusion is automatically dangerous. I'm saying that “the adjacent segment is under increased mechanical demand, therefore I should manipulate it” is an absurdly weak justification for applying additional mechanical force to an already altered system. Specificity doesn't make a questionable rationale good. Know the biomechanics. If you know someone with a spinal fusion, send them this video. And if you've ever been told your fused spine “needs to be adjusted,” tell me what you were told in the comments. #SpinalFusion #CervicalFusion #Chiropractic #PhysicalTherapy

#stitch with @Dr. James Ferraro If you have a spinal fusion, this is something I REALLY want you to understand before someone tells you that the segments next to your fusion “need to be manipulated.” A fusion eliminates motion at one spinal segment. That changes how motion and load are distributed throughout the rest of the spine, the adjacent-segment phenomenon. Biomechanical research has demonstrated increased motion and intradiscal pressure at the levels next to a cervical fusion. In one cadaveric study, intradiscal pressure increased 73% above the fusion and 45% below it during flexion. And this isn't just something we see in a laboratory. Hilibrand et al. reported symptomatic adjacent-segment disease occurring at approximately 2.9% per year, with an estimated 25% of patients developing symptomatic adjacent-segment disease within 10 years following cervical arthrodesis. Now here's where the logic gets ridiculous: “This segment is already taking on additional motion and mechanical demand…therefore I'm going to forcibly manipulate it because it needs more motion.” That's not an explanation of biomechanics. That's a contradiction. Adjacent-segment disease is multifactorial, and the evidence specifically examining manual therapy after cervical fusion is limited. A 2022 scoping review found only 12 relevant studies, with most being case reports, and concluded that there is insufficient high-quality evidence to establish the safety or clinical utility of manual therapy after cervical surgery. So no, I'm not saying every manual technique around every fusion is automatically dangerous. I'm saying that “the adjacent segment is under increased mechanical demand, therefore I should manipulate it” is an absurdly weak justification for applying additional mechanical force to an already altered system. Specificity doesn't make a questionable rationale good. Know the biomechanics. If you know someone with a spinal fusion, send them this video. And if you've ever been told your fused spine “needs to be adjusted,” tell me what you were told in the comments. #SpinalFusion #CervicalFusion #Chiropractic #PhysicalTherapy

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