Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation

Abstract

We investigated the effects of continuous lumbar traction in patients with lumbar disc herniation on clinical findings, and size of the herniated disc measured by computed tomography (CT). In this prospective, randomized, controlled study, 46 patients with lumbar disc herniation were included, and randomized into two groups as the traction group (24 patients), and the control group (22 patients). The traction group was given a physical therapy program and continuous lumbar traction. The control group was given the same physical therapy program without traction, for the same duration of time. Data for the clinical symptoms and signs were collected before and after the treatment together with calculation of a herniation index, from the CT images that showed the size of the herniated disc material. In the traction group, most of the clinical findings significantly improved with treatment. Size of the herniated disc material in CT decreased significantly only in the traction group. In the traction group the herniation index decreased from 276.6+/-129.6 to 212.5+/-84.3 with treatment (p<0.01). In the control group, pretreatment value was 293.4+/-112.1, and it decreased to 285.4+/-115.4 after the treatment (p>0.05). Patients with greater herniations tended to respond better to traction. In conclusion, lumbar traction is both effective in improving symptoms and clinical findings in patients with lumbar disc herniation and also in decreasing the size of the herniated disc material as measured by CT.

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

“…176,[242][243][244][245][246][247][248][249][250] One further study compared mixed treatment that included traction, with mixed treatments or with other comparators without traction (Table 57a). [253][254][255][256] Three studies compared different types of traction (Table 57b). 248,251,252 Summary of study participants for traction Summary data for included participants are presented in Table 58.…”

How is recovery from low back pain measured? A systematic review of the literature

“…isokinetic muscle test [4]). Nineteen measures were described in a vague or uninformative manner that would preclude replication [6,11,26,31,33,43,49,59,70,74,81,87,93,95,100]. Seventeen studies used a minimum level of pain or 'symptoms' as a proxy for recovery; however, no two studies did so in exactly the same way (Table 1).…”

“…Administrative data were used in four studies; two used return to work as the criterion [34,35,91], and two used time to insurance claim closure [14,34,35], and one further study used a self-rating of return to work [44] ( Table 4). Six studies measured physical performance or absence of neurological deficits [4,11,29,47,74,95], however in only three of these studies [4,29,47] was the test clearly described. Another aspect of recovery that varied widely among included studies is the duration for which patients had to meet the recovery criteria to be regarded as recovered.…”

Comparison of the intervertebral disc spaces between axial and anterior lean cervical traction

“…Spinal traction is generally regarded as a conservative management in treating various types of neck or back disorders. Several mechanisms have been proposed for the possible therapeutic effects of traction [5,10,17,21,27,28,36]. DeLacerda et al [5] reported that the axial traction reduced pain by improving circulation or preventing adhesions and contractures of spinal structures.…”

“…Krause et al [17] concluded that the separation of vertebrae by increasing the diameter of intervertebral foramen could reduce radicular pain and normalize neurological deficits by relieving direct pressure or contact forces in the sensitized neural tissues. Although the exact mechanisms for pain relief and function recovery are still controversial, the generally recognized biomechanical effects of cervical traction are to enlarge the intervertebral disc spaces around foramen levels and tighten the posterior longitudinal ligament [17,21,27,28,36].…”