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Spinal Decompression Literature Review & Discussion

November 22, 2010

Spinal decompression has been shown to decompress the disc space, and in the clinical picture of low back pain is distinguishable from conventional spinal traction.

According to the literature, traditional traction has proven to be less effective and biomechanically inadequate to produce optimal therapeutic results. In fact, one study by Mangion et al concluded that any benefit derived from continuous traction devices was due to enforced immobilization rather than actual traction. In another study, Weber compared patients treated with traction to a control group that had simulated traction and demonstrated no significant differences.

Research confirms that traditional traction does not produce spinal decompression. Instead, decompression, (i.e. unloading due to distraction and positioning of the intervertebral discs and facet joints of the lumbar spine), has been proven an effective treatment for herniated and degenerative disc disease, by producing and sustaining negative intradiscal pressure in the disc space. In agreement with Nachemon’s findings and Yong-Hing and Kirkaldy-Willis, spinal decompression treatment for low back pain intervenes in the natural history of spinal degeneration.

Matthews used epidurography to study patients thought to have lumbar disc protrusion. With applied forces of 120 pounds over 20 minutes, he was able to demonstrate that the contrast material was drawn into the disc spaces by osmotic changes.

Goldfish speculates that the degenerative disc may benefit by lowering intradiscal pressure, affecting the nutritional state of the nucleus pulposus.

Ramos and Martin showed by precisely directed distraction forces, intradiscal pressure could dramatically drop into a negative range.

A study by Onel et al reported the positive effects of distraction on the disc with contour changes by computed tomography imaging. High intradiscal pressures associated with both herniated and degenerated discs interfere with the restoration of homeostasis and repair of injured tissue.

Gionis, et al demonstrated that 86% of the 219 patients who completed decompression therapy reported immediate resolution of symptoms, while 84% remained pain-free 90 days post-treatment. Physical examination findings showed improvement in 92% of the 219 patients, and remained intact in 89% of these patients 90 days after treatment.

Although long-term outcome studies are needed to determine if spinal decompression therapy prevents, or merely delays surgery, recent advances in technology suggest promising results are obtainable in the effective back pain treatment of patients with disc herniation,sciatica, stenosis, and degenerative disc disease.

Latest Technology

Unlike some spine decompression devices such as Vax-D, where the distraction forces are created nonspecifically through the entire lumbar spine, the some of the latest technology is able to provide specific decompression to the exact disc level that is diagnosed from physical examination and the appropriate diagnostic imaging studies. The angle of decompression to the affected level causes a negative pressure intradiscally that creates an osmotic pressure gradient for fluid transfer into the degenerated and/or herniated disc, thereby providing an optimal environment for healing to occur. In addition, units like the SpineMed decompression unit is safe and will not affect the integrity of the shoulder joints as is the potential with Vax-D treatment.

 

Conclusion

Spinal decompression therapy is not a panacea for the treatment of back pain, but is an integral part of a comprehensive back pain treatment program. In association with a back pain exercise program, appropriate spinal bracing, and spinal education, you will benefit from the latest evidenced based technologies for the treatment of back pain.

Read more: http://www.disabled-world.com/artman/publish/back-pain.shtml#ixzz148SrICVq


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This post was written by Advanced Chiropractic and Wellness