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Mechanical Spinal Traction

Mechanical Spinal Traction. Veronica Southard PT MS GCS. Spinal Traction. Electronic units Pulling forces Longitudinal separation and gliding C or L segments or lengthening of soft tissues

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Mechanical Spinal Traction

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  1. Mechanical Spinal Traction Veronica Southard PT MS GCS

  2. Spinal Traction • Electronic units • Pulling forces • Longitudinal separation and gliding C or L segments or lengthening of soft tissues • There are several types of traction including; con’t bed traction, manual traction, Auto traction, Positional traction and Mechanical traction

  3. Goal • Reduction of signs or symptoms of C or L spinal compression • Utilize maximal traction with minimal force

  4. Physical Effects of Traction • Gentle stretch to joint capsule • Dependent upon the angle of pull and position of the spinal segments

  5. Effects Con’t • Increased inferior-superior dimensions of the intervertebral foramina • Elongation of posterior muscular tissues • Improved blood supply to posterior soft tissue and intervertebral discs • Altered intradiscal pressure

  6. Indications • Musculoskeletal signs: • Decreased sensation, motor function or reflexes, that are temporarily reduced with manual traction • General hypomobility of spine • Local spinal hypomobility and associated increased muscle tone that reduces with manual or positional traction

  7. Indications con’t • Musculoskeletal symptoms: • Numbness of extremity, pain, tingling that is temporarily relieved by manual or positional traction. • Central, unilateral or bilateral spinal pain reduced by manual or positional traction

  8. Common Indications • Spinal nerve root impingement due to DDD • Intradiscal pressure if treatment is 10 minutes or less. • Spinal nerve root impingement due to stenosis. Vertebral body separation, typically in a flexed direction • Generalized of hypomobility of L & C spine • M spasm resulting in nerve root impingement

  9. Contraindications • Absolute • 1. Spinal infections • 2. Spinal Ca • 3. Spinal Cord pressure • 4. RA • 5. Osteoporosis

  10. Contraindications: Relative • Ligamentous strains and hypermobility • Acute stage of injury • Traction anxiety • Cardiac or respiratory insufficiency • Pregnancy

  11. Patient instruction • Explain to patient • Position Pt. • C spine can be done in sitting or supine.Supine provides increased relaxation, vertebral separation and easier countertraction • L traction can be done supine or prone

  12. Angle of Pull • Angle of Pull • C spine Occiput ( C1-C2) 0-5 degrees flexion • Mid. Cervical (C2-C5) 10-20 flexion • Low cervical (C5-C7) 25-30 flexion

  13. Intervertebral Encroachment • Flex, and SB toward unaffected side and rotation toward affected side • Disc- C spine neutral. Want ligaments to be lax and allow better distraction

  14. Lumbar spine • Positioning for intervertebral encroachment is neutral for bilateral involvement. Unilateral SB toward good side with trunk rotated toward the affected side. • Facets are treated in flexion • Position: L5-S1= 45* hip flexion • L4-L5 = 60-75* HIP FLEXION • L3-l4 + 75-90* HIP FLEXION

  15. Traction Technique • Angle of pull • C spine supine better. 25* flexion • L spine Flex hip and knees, symmetrical or prone or unilateral technique

  16. Force • C spine start with 15#, Increase to 25#, Never exceed 50# • L spine 25% body weight, up to 50% body weight. Never exceed body weight. Nerve root problems may require only 25-60#. Start with low force

  17. Mode of treatment • Intermittent Most comfortable • On times generally between 7-20 sec • Off times 7 to 60 sec • On/Off ratio may be 1:1 or 3:1

  18. Static traction • Used less frequently. • Treatment times 8-25 minutes • Brief continuous for disc problems 10 minutes • Facet problems 15-20 minutes

  19. Other duration considerations • HNP Decrease time 5-8 minutes • DJD, Spondylolithesis up to 20’ • Frequency from 2-3 times per week up to daily • Allow the patient to rest a few minutes upon completion. Ask the patient f they have any dizziness or headache post treatment

  20. Document • A. Position • B. Angle of pull • C. Amount of force., hold and rest cycles • D. Static or intermittent • E. Duration • F. Pt. Response • Pain / changes • Functional changes

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