Vertebral Axial Decompression Therapy for pain associated with herniated or degenerated discs or facet syndrome: An outcome study
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They used water soluble contrast medium and epidurography to study 14 patients with prolapsed intervertebral disc syndrome before and after 10 to 15 days of continuous traction. Ten patients showed definite clinical improvement, with reduction in back pain and sciatica. Nine of these patients showed complete resolution of the defect on epidurogram and one of them showed partial reduction. The authors concluded that disc protrusion may be safely treated by traction. Mathews also demonstrated the effectiveness of lumbar traction in two patients by epidurography. Disc protrusions were decreased and an average vertebral distraction of 2 mm per disc space was shown in radiography (9). Judovich found that a traction force of approximately 26% of the body weight was needed just to overcome the resistance between the lower half of the patient and a (nonsplit) table (10).

Intuitively, lumbar traction should be successful in alleviating many of the conditions which cause low back pain and associated radiculopathy. Unfortunately, studies of clinical efficacy have yielded equivocal results. Previously, the successful application of lumbar traction has been limited by patient tolerance and the design of mechanical devices. Patients had difficulty tolerating the forces needed to relieve pain if delivered continuously. Furthermore, the thoracic corsets worn by patients to prevent movement on the table were uncomfortable, restrictred respiration, and can compromise venous return to the heart. Technological advances have now led to the development of equipment that has been found to achieve decompression of lumbar discs without stimulating the reactive reflexes of the lumbar musculature that can otherwise overcome efforts to effectively distract vertebral bodies. Figure 1: Patient undergoing spinal decompression treatment.

The split table design eliminates frictional resistance between the patient and the table and allows controllable effective axial distraction tensions to be applied to the lumbar vertebral column. The equipment applies distractive forces in a gradual, progressive fashion, designed to achieve distraction of the vertebral bodies without eliciting reactive reflex muscular resistance. A portion of a typical chart recording of the tensile force applied to a patient's spine as a function of time is shown in Figure 2.

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