Effects of Different Angles of the Traction Table on Lumbar Spine Ligaments: A Finite Element Study

Farajpour, Hekmat; Jamshidi, Nima

doi:10.4055/cios.2017.9.4.480

Cited by 14 publications

(11 citation statements)

References 11 publications

(18 reference statements)

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“…Even in the absence of standard protocol, such forces are note applied routinely in clinical practice. 27,28 The absence of representation of the ligaments is not the only limit of this model. The skin is also not represented in AMS, and the device had to be attached to the skeleton.…”

Section: Discussionmentioning

confidence: 99%

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Relevance of a novel external dynamic distraction device for treating back pain

Zaïri

Moulart²,

Fontaine³

et al. 2020

Proc Inst Mech Eng H

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Low back pain is a common, expensive, and disabling condition in industrialized countries. There is still no consensus for its ideal management. Believing in the beneficial effect of traction, we developed a novel external dynamic distraction device. The purpose of this work was to demonstrate that external distraction allows limiting the pressure exerted in standing-up position on the lower intervertebral discs. Numerical and cadaveric studies were used as complementary approaches. Firstly, we implemented the device into a numerical model of a validated musculoskeletal software (Anybody Modeling System) and we calculated the lower disc pressure while traction forces were applied. Secondly, we performed an anatomical study using a non-formalin preserved cadaver placed in a sitting position. A pressure sensor was placed in the lower discs under fluoroscopic control through a Jamshidi needle. The intradiscal pressure was then measured continuously at rest while applying a traction force of 200 N. Both numerical and cadaveric studies demonstrated a decrease in intradiscal pressures after applying a traction force with the external device. Using the numerical model, we showed that tensile forces below 500 N in total were sufficient. The application of higher forces seems useless and potentially deleterious. External dynamic distraction device is able to significantly decrease the intradiscal pressure in a sitting or standing position. However, the therapeutic effects need to be proven using clinical studies.

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Section: Discussionmentioning

confidence: 99%

“…Indeed, the cadaver was sitting slightly leaning forward, which can induce a slight inversion of curvature (lower lordosis) and increase the stresses exerted on the front of the disc. 27–29…”

Section: Discussionmentioning

confidence: 99%

Relevance of a novel external dynamic distraction device for treating back pain

Zaïri

Moulart²,

Fontaine³

et al. 2020

Proc Inst Mech Eng H

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“…In addition, the lumbar lordosis curve plays a pivotal role in maintaining sagittal balance. IVDs are closely related to various spinal diseases including low back pain (LBP) because they function as a shock absorber inside the spine and reduce friction between vertebral bodies [ 1 , 2 ]. The damage or degeneration of IVD can lead to the mechanical compression of the spinal nerve or chemical stimulation, consequently causing various symptoms such as LBP, osteoarthrosis, loss of cartilage, and osteophyte formation in the facet joints and may lead to the development of spinal stenosis or degenerative spondylolisthesis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The damage or degeneration of IVD can lead to the mechanical compression of the spinal nerve or chemical stimulation, consequently causing various symptoms such as LBP, osteoarthrosis, loss of cartilage, and osteophyte formation in the facet joints and may lead to the development of spinal stenosis or degenerative spondylolisthesis [ 3 ]. To solve spinal dysfunction and LBP, many treatment measures focused on improving and modifying IVD physiology have been gaining attention, and related studies are advancing rapidly [ 1 , 2 , 4 , 5 ]. Studies have reported that the lifetime prevalence of LBP is as high as 84% and known to cause massive individual and economic burdens in industrialized nations such as Korea [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Mechanical Changes of the Lumbar Intervertebral Space and Lordotic Angle Caused by Posterior-to-Anterior Traction Using a Spinal Thermal Massage Device in Healthy People

Yoon

Lee

et al. 2021

Healthcare

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Background: The axial (horizontal) traction approach has been traditionally used for treatment of low back pain-related spinal disorders such as nuclear protrusion, primary posterolateral root pain, and lower thoracic disc herniation; however, it is known to have some technical limitations due to reductions of the spinal curve. Lumbar lordosis plays a pivotal function in maintaining sagittal balance. Recently, vertical traction and combination traction have been attracting attention due to improving therapeutic outcomes, although evidence of their clinical application is rare; therefore, this study was conducted to investigate the mechanical changes of lumbar intervertebral space, lordotic angle, and the central spinal canal area through vertical traction treatment using a spinal massage device in healthy participants. Methods: In total, 10 healthy subjects with no musculoskeletal disorders and no physical activity restrictions participated. The participants lay on the experimental device (CGM MB-1901) in supine extended posture and vertical traction force was applied in a posterior-to-anterior direction on the L3–4 and L4–5 lumbar sections at level 1 (baseline) and level 9 (traction mode). Magnetic resonance (MR) images were recorded directly under traction mode using the MRI scanner. The height values of the intervertebral space (anterior, center, and posterior parts) and lordosis angle of the L3–4 and L4–5 sections were measured using Image J software and the central spinal canal area (L4–5) was observed through superimposition method using the MR images. All measurement and image analyses were conducted by 2 experienced radiologists under a single-blinded method. Results: The average height values of the intervertebral space under traction mode were significantly increased in both L3–4 and L4–5 sections compared to baseline, particularly in the anterior and central parts but not in the posterior part. Cobb’s angle also showed significant increases in both L3–4 and L4–5 sections compared to baseline (p < 0.001). The central spinal canal area showed a slightly expanded feature in traction mode. Conclusions: In this pilot experiment, posterior-to-anterior vertical traction on L3–4 and L4–5 sections using a spinal massage device caused positive and significant changes based on increases of the intervertebral space height, lumbar lordosis angle, and central spinal canal area compared to the baseline condition. Our results are expected to be useful as underlying data for the clinical application of vertical traction.

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“…Traction is a procedure that applies to SCI patients to degrade existing pressure, in which a gap is formed between articular facets within the joint. As a result, the compression of the spinal neural root, and in turn, the risk of inflammation will be decreased [17].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Pre-hospital Emergency Services, Non-Surgical Interventions, and Clinical Outcomes in Patients With Traumatic Spine

Andalib

Mohtasham-Amiri

Yousefzadeh-Chabok

et al. 2019

Iran. J. Neurosurg.

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Background and Aim:The aim of this study was to assess the pre-hospital emergency services, non-surgical interventions, and clinical outcomes in patients with traumatic spine referred to Poursina hospital in Guilan. Methods and Materials/Patients: Spine trauma registry of Poursina hospital of Rasht were used. Records of patients with traumatic spine were reviewed for pre-hospital emergency services, nonsurgical interventions, and clinical outcomes during 2015 to 2019.Results: 197 patients with traumatic spine were reviewed. 80.2% of the patients were transferred by ambulance. Pre-hospital fixation was performed in 59.4% of the patients (n=117). Pre-hospital intubation was required in 1% of patients (n=2). 4.6% of the patients had Glasgow Comma Scale (GCS) <9; 3% of them (n=6) had 9< GCS<12; and 92.4% had GCS≥13. 11.7% of the patients experienced SCI. 6.1%, 1%, 3%, 0.5%, and 1% of the patients suffered from paraplegia, paraparesis, quadriplegia, quadriparesis, hemiparesis, respectively. Surgery was performed in 89.8% of the patients. Traction was performed for 3.6% of the patients. Good recovery, moderate disabilities, severe disabilities, persistent vegetative state, and death were found in 85.8%, 2%, 5.1%, 1.5%, and 2.5% of the patients, respectively, according to Glasgow Outcome Scale. Conclusion:Most of the patients were transferred to the hospital by ambulance. Pre-hospital fixation was required in more than half of the patients. Most of the patients showed GCS≥13 and a good recovery outcome, according to GCS.

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Effects of Different Angles of the Traction Table on Lumbar Spine Ligaments: A Finite Element Study

Cited by 14 publications

References 11 publications

Relevance of a novel external dynamic distraction device for treating back pain

Relevance of a novel external dynamic distraction device for treating back pain

Mechanical Changes of the Lumbar Intervertebral Space and Lordotic Angle Caused by Posterior-to-Anterior Traction Using a Spinal Thermal Massage Device in Healthy People

Evaluation of Pre-hospital Emergency Services, Non-Surgical Interventions, and Clinical Outcomes in Patients With Traumatic Spine

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