title: Chiropractic management of post spinal cord stimulator spine pain: a case report.
abstract: BACKGROUND
  A brief overview of failed back surgery syndrome, with emphasis on low back pain status post spinal cord stimulation, and post-surgical spinal manipulation is presented.
  
  
  METHODS
  Four cases of patients within the VA Connecticut Health Care System presenting between July 2014 and July 2015 reporting low back pain after surgical insertion of spinal cord stimulators are discussed. This study describes the outcomes experienced by four patients with low back pain status post implanted spinal cord stimulators receiving manual therapy in the form of lumbar spine manipulation or mobilization.
  
  
  CONCLUSIONS
  All four patients denied adverse effects to spinal manipulation/mobilization and onset of new symptoms after treatment; two patients reported durable reduction in low back pain with increased tolerance to walking, standing, or lying down, one reported temporary relief of low back pain, and one reported no change in symptoms. Further investigation is needed to determine the benefit of spinal manipulation in patients with implanted spinal cord stimulators, but this study has shown the absence of adverse effects from manipulation or mobilization treatment, in regards to SCS.
authors.affiliation: Michael E. DeBakey VA Medical Center, Rehabilitation Care Line, 580/RECL 117, 2002 Holcombe Boulevard, Houston, TX 77030 USA.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Perrucci
authors.affiliation: VA Connecticut Healthcare System, Physical Medicine and Rehabilitation, 950 Campbell Ave, West Haven, CT 06516 USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Coulis
keywords: Chiropractic; Failed back surgery syndrome; Post-surgical spine pain; Spinal cord stimulator