A Multimodal Approach Including Spinal Decompression for Cervical Herniated Disc: A Retrospective Case Series

Abstract

Background: Cervical herniated discs are a significant source of neck pain and functional disability, often leading patients to consider invasive surgical options. Conservative management strategies are sought to alleviate symptoms and improve quality of life. This article reviews outcomes for patients treated with a multimodal chiropractic protocol. Methods: A retrospective case series was conducted on eight adult patients with a diagnosis of cervical herniated disc (ICD-10: M50.20) at a single chiropractic wellness center in Miami, FL. Patients underwent a customized treatment protocol centered around non-surgical spinal decompression therapy, supplemented with therapeutic exercises and postural rehabilitation. Pre- and post-treatment pain levels were recorded using a 10-point numeric rating scale. Results: The cohort of eight patients (n=8) reported a mean pain reduction of 92% and a median pain reduction of 93%. Patients consistently reported significant functional improvements, including the ability to return to work, resume recreational activities, and avoid previously recommended surgeries. Conclusions: The findings from this case series suggest that a multimodal conservative care protocol featuring spinal decompression may be a highly effective treatment for pain reduction and functional restoration in patients with cervical herniated discs. These results highlight a potential non-surgical alternative, though further research with more rigorous controlled study designs is warranted.

Methods

This study was conducted as a retrospective case series analyzing patient outcomes at Shin Wellness, a chiropractic and wellness center in Miami, Florida. The records of patients treated by Dr. Wendy Gallego and her team were reviewed to identify a cohort for this analysis. Inclusion criteria required patients to have a diagnosis of cervical herniated disc (consistent with ICD-10 code M50.20), to have completed a full course of prescribed treatment at the clinic, and to have documented pre- and post-treatment pain scores. A total of eight patient files meeting these criteria were included in the series.

The treatment protocol was multimodal and customized for each patient but was centered around non-surgical spinal decompression using a DRX9000 system. In addition to decompression therapy, treatment plans for this cohort universally included therapeutic exercise and postural rehabilitation. Other modalities available at the clinic, such as chiropractic adjustments, acupuncture, cold laser therapy, and pulsed electromagnetic therapy (PEMF), may have been utilized as part of a comprehensive care plan, though the primary intervention analyzed was the decompression-focused protocol.

The primary outcome measure was the change in self-reported pain intensity, documented using a 10-point numeric rating scale (NRS), where 0 represents 'no pain' and 10 represents 'the worst pain imaginable'. Data on initial and final pain scores were extracted from patient records. The percentage of pain reduction was calculated for each patient, and the mean and median reduction for the cohort were determined. Qualitative data on functional improvements were also extracted from narrative notes within the patient charts.

Discussion

The results of this retrospective case series suggest that a multimodal conservative treatment program, with a core component of non-surgical spinal decompression, can lead to substantial improvements for patients with symptomatic cervical disc herniations. The observed mean pain reduction of 92% across a cohort of eight patients is a clinically significant finding. This high level of pain relief indicates that this non-surgical approach may be a powerful tool in managing a condition that often proves refractory to other conservative treatments.

Beyond pain reduction, the narrative reports from patient files highlight corresponding gains in functional capacity. Patients reported returning to full-time work, resuming athletic activities, and achieving undisrupted sleep. These functional outcomes are arguably as important as the pain scores, as they represent a tangible restoration of quality of life. The ability for patients to avoid more invasive procedures, such as steroid injections or spinal surgery, as reported in several cases, is a critical clinical implication. By providing a viable non-surgical alternative, this approach aligns with a patient-centered, least-invasive model of care.

The consistency of positive outcomes across a varied patient demographic—spanning different ages and initial functional limitations—suggests a broad applicability of the treatment protocol. The use of a multimodal strategy, combining the mechanical effects of spinal decompression with the supportive benefits of therapeutic exercise and postural rehabilitation, likely creates a synergistic effect that addresses the condition more comprehensively than any single modality in isolation. Decompression may address the disc pathology directly, while rehabilitative exercises strengthen supporting structures and improve biomechanics to prevent recurrence. While promising, these results must be interpreted within the context of the study's design limitations.

Limitations

This study has several important limitations inherent to its design. As a retrospective case series, it lacks a control group, making it impossible to definitively attribute the observed improvements to the treatment intervention alone. The natural history of the condition or placebo effects could have contributed to the outcomes. Furthermore, the data was collected from a single clinical site, Shin Wellness in Miami, FL, which may limit the generalizability of the findings to other patient populations or clinical settings. The primary outcome measure, a self-reported pain scale, is subjective by nature. There is also a potential for selection bias, as the series includes only patients who completed the full course of treatment. Patients who discontinued care early, possibly due to a lack of improvement or other factors, were not included in this analysis. Prospective, randomized controlled trials are necessary to overcome these limitations and establish a causal relationship between this multimodal protocol and patient outcomes.