Monday, May 21, 2012
Spinal Decompression is a state of art technology used primarily to treat disc injuries in the neck and in the low back. Spinal Decompression is often a non-surgical and drug-free answer for disc related problems of the lumbar or cervical spine. Many people across the continent and around the world have found relief from the pain associated with herniated discs, bulging discs, facet syndrome, degenerative joint disease, pinched nerves, and other spinal afflictions from decompression therapy. Spinal Disc Decompression uses computer-aided technology to apply gentle decompression to the spine which increases circulation into the spinal discs and joints, thus helping to relieve the symptoms that cause pain and dysfunction.
Bulging discs, degenerative disc disease, facet syndrome and spinal arthritis may be a candidate for non-surgical spinal decompression. Spinal Decompression is an effective treatment for pinched nerves, sciatica, bulging and for some herniated discs, radiating arm or neck pain, headaches, degenerative disc disease and facet syndrome.
Lower back pain patients can be positioned on their back or stomach, for degenerative discs the second position called “prone” may be more comfortable. This design is a feature of the Triton DTS table that is missing from many other tables. Once positioned on the table, padded straps are used to securely fasten the patient for treatment. For neck patients, the patient is put on their back in a semi-seated position where a soft rubber neck harness is used for the treatment. Once in place for the treatment the computerized equipment starts to pull in small increments, as set by a trained doctor. By the use of small increments of increasing force, the body is allowed to relax which enables the treatment to be more effective and more comfortable than the first non computer assisted types of traction. Once the desired amount of tension is reached it is held 45-60 seconds (dependent on the condition) followed by a 30 second interval of a decreased amount of tension (approximately half of the upper limit). This continues for 15-25 minutes and then is followed by a slow incremental lowering of tension until no tension is left on the patient. The usual plan is for 20-25 treatments. Treatments are frequent to maximize the imbibing of the disc and allow the body to heal.
Spinal Decompression is different from standard traction because traction is a simple static force that is put on the patient's body with the intent of unloading the body's joints, muscles and other structures. For example, hanging upside-down is a common method to put the spine into traction. Rather than one's body weight putting stress on the spine, which is what happens when standing, the body weight is working to unload the spine. Spinal Decompression works via a pumping action type of traction, the pumping action of the table does two things:
1. First the table pulls on your spine it slowly stretches your spine and increases the space between the two spinal bones (the disc space). This creates a negative pressure or vacuum in the disc which helps to suck the disc back inwards and away from the nerve that is being pinched. Although the amount is very small each treatment, with consecutive treatments it creates more space for the nerve and decreases the size of the disc herniation.
2. Secondly, the gentle stretching and relaxation of the spine promotes nutrition intake by the discs known as imbibition. Discs normally receive their nutrition by this imbibition during spinal movement but this process is hampered in disc damage or degeneration. A disc with fewer nutrients and less hydration is more prone to injury. Increased level of nutrients in the disc allows the disc to have the nutrition it needs to speed up the healing process. Spinal decompression increases the nutrients to the disc by bathing of the cartilage with joint fluid which allows discs to heal more rapidly. Studies have shown that the disc size can increase 1-3mm over the treatment cycle that is provided. Although that seems a small amount it can have a large influence on the space needed to get pressure off of the sensitive nerves in the area. The opening for the nerves to exit the spine depends on the size of the disc. When the disc rehydrates and heals then the pressure is relieved from the spinal nerves and pain is lessened.
Spinal Decompression does not work for all spinal conditions, for instance a free floating disc fragment will not rejoin the disc it was sequestered from. Several published peer reviewed studies demonstrated patients having had good to excellent clinical improvements 82%-93% of the time.
Typically, dramatic improvements are seen with sciatica (pain or pins and needles radiating down one or both legs), radiating neck pain (pain or pins and needles radiating down to shoulders, arms or into hands) and severe acute low back pain.
Very good improvements are seen in chronic neck pain and chronic low back pain. For more difficult conditions, such as spinal stenosis or patients with significant bone spurring, the success rates are somewhat lower but still higher than a lot of the other options out there. Research on the effectiveness of Spinal Decompression: one recent clinical study of 219 patients has shown that spinal decompression therapy provided a resolution of symptoms for 86% of the participants who completed their therapy, while 84% remained pain-free 90 days post-treatment.
Clinical Trials: In a recent journal article in Orthopedic Technology Review titled Surgical Alternatives: Spinal Decompression, results showed that 86% of the 219 patients who completed the therapy reported resolution of symptoms while 84% of patients remained pain free 90 days post treatment. Physical examination findings showed improvement in 92% of the 219 patients, and remained intact in 89% of these patients 90 days after treatment.
Another article in Journal of Neurological Research reported that vertebral axial [spinal] decompression was successful in 71% of the 778 cases. The success rate varied from 73% for patients with a single herniated disc. It was 72% for people with multiple herniated discs.
The American Journal of Pain Management reported "good to excellent" relief in 86% of patients with herniated discs, with back pain and sciatica symptoms being relieved. Good to excellent results were also obtained in 75% of those with facet syndrome.
A small non-randomized study in Anesthesiology News reported of the 23 patients who responded to therapy, 52% had a pain level of zero, 91% were able to resume their normal daily activities, and 87% were either working or were retired without having back pain as the cause of retirement.
The study at the Rio Grande Hospital, Department of Neurosurgery compared the effects of 20 treatment sessions vs. 10 treatment sessions on chronic low back pain sufferers. The group receiving 20 treatments of decompression therapy reported a 76.5% with complete remission and 19.6% with partial remission of pain and disability. The second group, receiving 10 treatments of decompression therapy, reported a 42.9% rate of remission and 24.1% with partial remission. Failure rate was only 3.9% for those receiving 20 treatment sessions while it was 32.9% for those receiving only 10 sessions. Remission was defined as 90% or greater relief of pain, back to work without limitations, and abilities to carry out Activities of Daily Living (ADL's). Partial remission was defined as persistence of some pain but ability to carry out most ADL's and return to work with some restriction of duties, depending on the occupation. Failure rate was defined as no change in the level of pain and or/ADL.
As you can see from the above referenced clinical trials, Spinal Decompression Therapy is an effective therapy for people experiencing discogenic or arthritic pain (pain arising from the disc or caused by various types of Spinal Arthritis). In addition, promising research suggests that the effects of Spinal Decompression Therapy can be a long-lasting solution to certain chronic back pain disorders. Although failure rates are relatively low, studies suggest that completion of prescribed treatments can reduce failure rates from 32.9% to 3.9%. Some conditions may require a spinal surgery such as minimally invasive surgical procedures or even full-blown spinal fusion surgeries.
Pain relief with other forms of traction has been inconsistent and short-lived with past techniques. In fact, several clinical studies have shown traction to be an ineffective form of back and neck pain relief. The reason is that our bodies react to the stretching of the spine by contracting, or squeezing, the muscles surrounding the spine thereby increasing the pressure on the spine thus increasing the disc pressure.
Spinal Decompression, on the other hand, is a modified, updated form of traction. Computer technology assists controlling variations in the unloading of the spine, effectively avoiding the body's response of muscle contraction; the traction tension is varied over time according to a program. The doctor can control how many progressive tension steps are experienced by the patient before reaching the maximum tension. The doctor also has complete control over how long the tensions are held steady and how often they are repeated.
Because Spinal Decompression avoids the muscle contraction response, the pressure within the disc is actually lowered to the point of being a vacuum, creating a negative pressure. This vacuum is what allows protruding disc material to be drawn back into place and permits rehydration of the disc. Once the protruding material is not in contact with the nerves and the disc is in good health, pain is relieved. For disc herniation, surgery can prove to be a successful option; however there are inherent and significant risks associated with any surgical procedure. Spinal Decompression is keeping a significant number of surgical candidates from ever having surgery. It is responsible to weigh the safety and success rates of different treatments. Studies have shown the success rate of spinal surgery to be around 50% (depending on the severity of the condition and the skill of the surgeon). As well, one must take into consideration the lengthy recovery time involved post-surgery often resulting in missed work and decreased quality of life. Compare that to the studies above (70-90% effective) and you will see that the conservative, non-surgical approach used with spinal decompression is an efficient form of treatment for those patients who are good candidates and should likely be tried before surgery as it is much less invasive.