Jioun Choi, MS, PT, Sangyong Lee, PhD, PT, Gak Hwangbo, PhD, PT
Purpose: The purpose of this study was to identify how spinal decompression therapy and general traction therapy influence the pain, disability, and straight leg raise (SLR) ability of patients with intervertebral disc herniation.
Subjects: The subjects were 30 patients with chronic lumbar pain who were divided into a spinal decompression therapy group (SDTG, n=15), and a general traction therapy group (GTTG, n=15).
Methods: The SDTG used a spinal decompression device, and the GTTG used a lumbar traction device. Both groups received conservative physical therapy three times a week for four weeks. A visual analog scale (VAS) was used to measure the degree of pain the patients with chronic lumbar pain. The Oswestry Disability Index (ODI) was used to measure the degree of functional disability. A goniometer was used to measure the patients’ SLR ability.
Results: Both SDTG and GTTG showed statistically significant decreases in VAS and ODI scores and a statistically significant increase in SLR angle. A comparison of the two groups found no statistically significant differences.
Conclusions: Spinal decompression therapy and general traction therapy are effective at improving the pain, disability, and SLR of patients with intervertebral disc herniation. Thus, selective treatment may be required.
Ibrahim Shady, Hamada Mohamed ahmed, Sherif Refaat, Ossama Komber
Introduction: LBP (Low Back Pain) is a common musculoskeletal symptom that may be caused by a variety of diseases and disorders that affect the lumber spine as chronic lumber disc herniation (CLDH).
Aim: To detect the differences between clinical effects of maintained Vis non-maintained non-surgical spinal decompression therapy (NSSDT) in patients with CLDH.
Subjects and Methods: 96 patients with CLDH were randomized into two matched groups. Both groups received 18 NSSDT sessions over a 5-week period (phase 1) followed by six months (phase 2) where only the maintained NSSDT group received one NSSDT session every two weeks.
Results: By the end of the phase 2 a significantly higher difference in the disc height in the maintained NSSDT group (95% CI, 0.6; 2.48, p=0.002) while the disc herniation index is significantly lower when compared to the non-maintained NSSDT group (95% CI, 106.8; 30.8, p<0.001). Also, the Oswestry disability score was decreased significantly more in the maintained NSSDT group.
Conclusions: Patients with chronic LBP caused by CLDH are benefited from treatment with maintained NSSDT to sustain the improved post-treatment pain, disability scores and the gained spinal mobility.
Lidija Pavlović, Dalibor Kiseljak, Olivera Petrak
Cervicobrachial syndrome greatly impairs the smooth performance of activities of daily living and professional activities, and is the subject of many studies. Compression of neurological structures due to herniated intespinal disc, with sensomotor deficits is an indication for surgical treatment. In recent years, interest for the traction (decompression) as a treatment modality has increased and many new methods based on the neurophysiological and biochemical principles have been developed. Therefore, the traction is applied in the treatment of various conditions increasingly. Spinal decompression therapy is an non-invasive approach to the cervicobrachial syndrome treatment. The objective of this study is to verify the performance of spinal decompression therapy measured as an outcome of the specific neurodynamic tests in patients with cervicobrachial syndrome, and to determine the relationship between socio-demographic factors and the success of the spinal decompression therapy in cervicobrachial syndrome. The sample was comprised of 50 participants (54% women), with cervicobrachial syndrome, aged 28-68 years, with a mean of 50. Acute symptoms were present in 62% of patients and chronic in 38%. The frequency of therapy sessions ranges from 3 to 8, with dominant value 4. For the purposes of the research three specific tests were used: Slump Test, Spurling’s test and cervical distraction test. After finalization of the spinal decompression therapy patients with the cervicobrachial syndrome differ significantly in the results on the Slump test, Spurling’s test and cervical distraction test, compared to the pre-treatment status: after treatment there are significantly more patients who successfully pass these tests. From the analyzed socio-demographic features, age of the participants seems to be significant: participants who successfully solved Slump and Spurling’s post-treatment tests, were significantly younger than the unsuccessful. After therapy, chronic patients had significantly lower performance in all the three tests, in comparison to the acute patients, and these two groups also differ in age: chronic patients were significantly older, while in the number of the therapy sessions attendance were not found significant differences. In the regression analysis, duration of the problem has proven to be a significant predictor, and the age a non-significant. Gender, weight and the number of therapy sessions are not related to the assessment outcomes
Marie Jurecki-Tiller, Ph.D., Wendy Bruening, Ph.D., Stephen Tregear, D.Phil., Karen Schoelles, M.D., S.M. Eileen Erinoff, B.A., Vivian Coates, M.B.A.
This report is based on research conducted by the ECRI Institute Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0019). The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.
The information in this report is intended to help health care decision-makers; patients and clinicians, health system leaders, and policymakers, make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.
Dwain M Daniel
Background: Traction therapy has been utilized in the treatment of low back pain for decades. The most recent incarnation of traction therapy is non-surgical spinal decompression therapy which can cost over $100,000. This form of therapy has been heavily marketed to manual therapy professions and subsequently to the consumer. The purpose of this paper is to initiate a debate pertaining to the relationship between marketing claims and the scientific literature on non-surgical spinal decompression.
Discussion: Only one small randomized controlled trial and several lower level efficacy studies have been performed on spinal decompression therapy. In general the quality of these studies is questionable. Many of the studies were performed using the VAX-D® unit which places the patient in a prone position. Often companies utilize this research for their marketing although their units place the patient in the supine position.
Summary: Only limited evidence is available to warrant the routine use of non-surgical spinal decompression, particularly when many other well investigated, less expensive alternatives are available.