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Lumbar Traction

Lumbar Traction. Chapter 17. Lumbar Traction. Comparison: Cervical and Lumbar Traction Similar Separating the vertebrae Difference:

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Lumbar Traction

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  1. Lumbar Traction Chapter 17

  2. Lumbar Traction • Comparison: Cervical and Lumbar Traction • Similar • Separating the vertebrae • Difference: • Friction, muscle, soft tissue tension, and weight of the lower extremity is a strong counterforce in lumbar traction, requiring more tension to separate the vertebrae • Force is approximately ½ the body weight • Split table reduces friction • Patient position has more influences on angle of pull in lumbar traction

  3. Indications • Spinal nerve impingement • Disk herniations • Muscle spasm • Radicular pain

  4. Contraindications • Pain of unknown origin • Acute injury • Unstable spinal segments • Cancer, meningitis, or other spinal cord/ vertebrae disease • Vertebral fracture • Extruded disk fragments

  5. Patient Position: Supine • Increases flexion • Supine and Flexion • Further increases flexion • 46-60: L5-S1 • 60-75: L4-L5 • 75-90: L3-L4 • 90: Posterior intervertebral space • Extension • Opens facet joints and increases distraction in upper lumbar

  6. Patient Position: Prone • Used when excessive flexion or lying supine causes pain • Benefits: • Allows other modalities to be used during traction • Effects the lower disk protrusions • Optimal Position • Experience • Trial and error

  7. Types of Lumbar Traction • Inversion • Gravitational • Autotraction • Mechanical

  8. Inversion Traction • Suspended upside down • Lengthens spine by the weight of the patient • Hazards • Hypertension • Cardiovascular • Glaucoma

  9. Gravitational Traction • Patient is Upright • Can increase posterior disk space between L1-S1 • Torso harness may be uncomfortable

  10. Autotraction • Support body weight by hanging from a bar or arm chair • Relaxing spinal muscles can distract vertebrae

  11. Mechanical Traction Application • Motorized lumbar traction • Determine body weight • Remove material that may interfere with halter • Adjust halter accordingly • Traction halter: Pelvis • Stabilization harness: 8th-10th Ribs

  12. Mechanical Traction Application • Unlock split table and align target spinal segment over the opening in the table • Secure and connect halter • Align angle of pull to correspond with specific pathology • Explain treatment to patient and give safety switch

  13. Initiation of Treatment • Set controls to zero and turn on unit • Adjust ratio • Tension • Approximately 25% of body weight • Radicular pain caused by disk herniation: 30 to 60% of body weight • Duration • Corresponding to pathology • Instruct patient to remain relaxed

  14. Termination of Treatment • Tension • Gradually reduce over 3 or 4 cycles • Gain slack and turn unit OFF • Many units have an auto OFF sequence • Remove halter from unit and patient • Patient remains in position for 5 minutes after the treatment

  15. Manual Traction • Helps determine the direction and amount of force to apply mechanically • In rare instances manual traction can be substituted for mechanical traction • Can be applied using a belt that allows the clinician’s body weight to deliver the force

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