Spinal Traction Overview

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Spinal TractionOverview

• Chapter 17

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Purpose

• Force that separates the vertebrae, opening the
  intervertebral space
• Effects
• Decreased pressure on intervertebral disks
• Decreased pressure spinal nerve rots
• Opens facet joints
• Elongates tissue
• Body areas
• Cervical
• Lumbar/pelvis

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Types of Traction

• Sustained
• Continuous, small force for an extended period
  (appx. 45 min)
• Intermittent
• Alternately applied and withdrawn traction
• Manual
• Administered by the clinician
• Positional
• Body positioning to elongate the involved tissue

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General Principles

• Angle of pull
• Neutral Transverse plane
• Flexion/Extension Frontal plane
• Unilateral Sagittal plane
• Multiaxial Two or more planes
• Anatomical differences
• Cervical inferior facet joints angle anteriorly
• Flexion opens facet joints
• Lumbar facets angled posteriorly
• Extension opens facet joints

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General Principles

• Tension
• No clear formula
• The traction must overcome the resistance exerted
  by the soft tissue
• Use the least amount of tension needed to relieve
  symptoms
• Duration is inversely related to tension

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Physiological Effects

• Encourages movement of spine between each
  vertebra
• Improves circulation
• Increases metabolism
• Enhances nutrition
• ROM increases dependent on
• Patient position
• Amount of force applied
• Type of traction
• Treatment time

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Indications

• Disk protrusions
• Degenerative disk disease
• Nerve root compression
• Facet joint pathology
• Muscle spasm

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Contraindications

• Acute injury
• Unstable spinal segments
• Cancer, meningitis, or other spinal cord/
  vertebrae disease
• Vertebral fracture
• Extruded disk fragments

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Intervertebral Disks and Disk Lesions

• Anatomy
• Annulus fibrosus
• Nucleus pulposus
• Dehydration
• Decrease range of motion narrowing intervertebral
  foramen
• Weakens annulus fibrosis
• Day vs. night
• Age

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Disk protrusion

• Body weight and muscle tone compress the disk and
  force the nucleus pulposus posteriorly
• Traction
• Decreases the pressure
• Increases disk hydration
• Imbibe
• Traction applied for too long can absorb too much
  fluid

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Intervertebral Foramen Stenosis

• Anatomy
• Intervertebral foramen
• Opening for 31 pairs of spinal nerve roots
• Disk degeneration
• Narrowing of intervertebral space
• Osteophytes
• Decrease opening
• Inflammation of nerve sheaths

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Facet Joint Pathology

• Healthy facets transmit approximately 20 of the
  body weight
• Inflamed facets transmit approximately 47 of
  body weight (lumbar spine)
• Traction can open the facet joints

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Muscle Spasm

• Long, slow stretching can reduce tonic muscle
  contraction by elongating the involved fibers
• Intermittent traction promotes relaxation during
  the OFF phase
• Increased diameter of the intervertebral foramen
  decreases muscle spasm
• Reduced pressure on spinal nerve roots

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Maintenance

• Cleaning
• Follow manufacturers instructions for unit and
  harness
• Avoid liquids from entering unit
• Check cords and traction cable
• Recalibrate unit
• Unit must be inspected and serveced by a
  technician annually