Intermittent Cervical Traction and Thoracic Manipulation for Management of Mild Cervical Compressive Myelopathy Attributed to Cervical Herniated Disc: A Case Series

Abstract

3Study Design: Case series. Objective: To describe the management of 7 patients with grade 1 cervical compressive myelopathy attributed to herniated disc using intermittent cervical traction and manipulation of the thoracic spine. Background: Intermittent cervical traction has been indicated for the treatment of patients with herniated disc and has been suggested to be helpful for patients with cervical compressive myelopathy. Manipulation of the thoracic spine has been utilized to safely improve active range of motion and decrease pain in patients with neck pain. Methods and Measures: Seven women with neck pain, 35 to 45 years of age, were identified as having signs and symptoms consistent with grade 1 cervical compressive myelopathy. Symptom duration ranged from less than 1 week to 52 weeks. All patients were treated with intermittent cervical traction and thoracic manipulation for a median of 9 sessions (range, 2-12 sessions) over a median of 56 days (range, 14-146 days). Numeric Pain Rating Scale and Functional Rating Index scores served as the primary outcome measures. Results: The median decrease in pain scores was 5 (range, 2-8) from a baseline of 6 (range, 4-8), and median improvement in Functional Rating Index scores was 26% (range, 10%-50%) from a baseline of 44% (range, 35%-71%). Dizziness was eliminated in 3 out of 4 patients and chronic headache symptoms were improved in 3 out of 3 patients. There were no adverse events or outcomes. Conclusions: Intermittent cervical traction and manipulation of the thoracic spine seem useful for the reduction of pain scores and level of disability in patients with mild cervical compressive myelopathy attributed to herniated disc. A thorough neurological screening exam is recommended prior to mechanical treatment of the cervical spine.

Effect of Mulligan upper cervical manual traction in the treatment of cervicogenic headache: a randomized controlled trial

“…However, upper cervical rotation RoM improved significantly in the MUCMT group when compared with the TT group. our results are supported by Browder et al [34], who declared that cervical traction in the intermittent mode in addition to manipulation significantly enhanced neck RoM and reduced pain. Buyukturan et al [12] detected a significant improvement in pain, RoM, and disability using Mulligan manual approaches in cervical dysfunction.…”

A Study on the Effectiveness of Manual Mulligan Traction Compared to Intermittent Electrical Traction in Patients with Cervical Spondylosis

“…In cervical traction, 1/8 th of the total body weight was applied 9 . The therapeutic effect of electrical traction is based on sustained and reflex mechanism 10 . Spinal elongation through increased intervertebral space and relaxation of the spinal muscles is assumed to have the most important role in the proposed mechanism by which IET could be effective 11 .…”