Background and Objectives: Lumbar traction is widely used as a non-operative treatment for lumbar intervertebral disc disease. The effect of traditional traction (TT) using linear-type traction devices remains controversial for various reasons, including technical limitations. Thus, the purpose of this study was to compare the effects of the newly developed lumbar lordotic curve-controlled traction (L-LCCT) and TT on functional changes in patients and morphological changes in the vertebral disc. Materials and Methods: A total of 40 patients with lumbar intervertebral disc disease at the L4/5 or L5/S1 level as confirmed by magnetic resonance imaging were recruited and divided into two groups (L-LCCT or TT). The comprehensive health status changes of the patients were recorded using pain and functional scores (the visual analogue scale, the Oswestry Disability Index, and the Roland–Morris Disability Questionnaire) and morphological changes (in the lumbar central canal area) before and after traction treatment. Results: Pain scores were significantly decreased after traction in both groups (p < 0.05). However, functional scores and morphological changes improved significantly after treatment in the L-LCCT group only (p < 0.05). Conclusions: We suggest that L-LCCT is a viable option for resolving the technical limitations of TT by maintaining the lumbar lordotic curve in patients with lumbar intervertebral disc disease.
The newly developed cervical lordotic curve-controlled traction (C-LCCT) appears to be an ideal method to improve the treatment outcome in patients with cervical intervertebral disc disease. The purpose of this study was to investigate the treatment outcomes of C-LCCT including the functional and morphological changes of the cervical intervertebral disc compared to traditional traction (TT) with a randomized controlled trial design. A total of 40 patients with cervical intervertebral disc disease at the C5/6 level confirmed by magnetic resonance imaging were recruited and assigned to either the C-LCCT group or the TT group. The comprehensive health status changes of the patients were recorded using pain and functional scores (Visual Analogue Scale, Oswestry Disability Index) and morphological changes (cervical lordosis, cervical central canal area) before and after the traction treatment. Both groups showed a significant improvement in pain scores after traction (p < 0.05). The functional score and morphological changes improved significantly after treatment in the C-LCCT group. However, there was no significant improvement in the TT group (p < 0.05). The C-LCCT showed significant pain, functional, and morphological improvement compared to TT. C-LCCT could be effective in improving the treatment outcomes of the traction technique in patients with cervical intervertebral disc disease.
Background: A standard spinal traction (ST) device was designed to straighten the spine without considering physiological lumbar lordosis. Using lordotic curve-controlled traction (LCCT), which maintains the lordotic curve during traction, the traction force would be applied to the posterior spinal structure effectively. Thus, the purpose of our study was to evaluate real-time biomechanical changes while applying the LCCT and ST. Methods: In this study, 40 subjects with mild non-radicular low back pain (LBP) were included. The participants underwent LCCT and ST in random order. Anterior and posterior intervertebral distance, ratios of anterior/posterior intervertebral distance (A/P ratio), and lordotic angles of intervertebral bodies (L2~L5) were measured by radiography. Results: Mean intervertebral distances were greater during LCCT than those measured prior to applying traction (p < 0.05). Mean A/P ratio was also significantly greater during LCCT than during ST or initially (p < 0.05). In particular, for the L4/5 intervertebral segment, which is responsible for most of the lordotic curve, mean LCCT angle was similar to mean lordotic angle in the standing position (10.9°). Conclusions: Based on measurements of radiologic geometrical changes with real-time clinical setting, the newly developed LCCT appears to be a useful traction device for increasing intervertebral disc spaces by maintaining lordotic curves.
Background: We previously invented a new technique to measure the cross-sectional area of soft tissue of a limb (DCSA) with lymphedema using ultrasonography. The measurement correlated strongly with both circumference and volumetry in normal subjects. The purpose of this study was to measure the reliability and accuracy of the method in patients with lymphedema. Methods and Results: Ultrasonography was performed on both arms of 69 female patients diagnosed with stage ‡1 lymphedema related to advanced breast cancer. At 10 cm above elbow (AE) and below elbow (BE), softtissue thicknesses at various locations were measured by two examiners. Subcutaneous tissue stiffness was also obtained by measuring thickness differences of soft tissue when applying minimal and maximal pressure to the skin (compliance) and its ratio to the initial thickness (compliance ratio). DCSA showed a strong positive correlation with circumference (r = 0.758 to 0.951), and a moderate negative correlation with Z at 5 Hz (r = -0.326 to -0.486). Intra-and interclass coefficients of all ultrasonography measurements were moderate to excellent (0.623-0.990). Compliance measured at 10 cm BE on the lesion side was significantly higher than on the normal side ( p < 0.001), and compliance measured at 10 cm AE showed no difference between the two sides ( p = 0.653). Conversely, compliance ratios measured at 10 cm AE and BE on the lesion side were significantly lower than on the normal side ( p < 0.001). Conclusion: Thus, DCSA using ultrasonography could be a particularly viable option for determining status in lymphedema patients.
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