Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Modalities > Spinal Traction > Flashcards

Spinal Traction Flashcards

1
Q

Effects of Traction

A
  • distraction of vertebral bodies
  • –> creates suction force to draw discs toward neutral position = more room = less pressure
  • –> alters pressure of intervertebral discs
  • distraction and/or gliding on facets
  • flattens lumbar curvature
  • tensing of segmental ligaments
  • widening of lateral foramen
  • decreases pressure on injured tissue
  • stretching of spinal muscles
  • relaxation of spinal muscles
  • improves peripheral circulation
    • research does not support any LASTING effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of disc herniation

A

stage 1: protrusion
stage 2: prolapse
stage 3: extrusion (nucleus pulpous breaks through annulus fibrosis)
stage 4: sequestered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Traction will provide pain relief for which types of disc herniation

A

protrusion

minor prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications

A
  • HNP
  • facet impingement / malalignment
  • facet joint hypo mobility
  • DDD / DJD (discs essentially melt away)
  • stenosis “narrowing”
    • central stenosis: narrowing of vertebral foramen
    • lateral stenosis: narrowing of lateral foramen
  • muscle spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Benefits of traction for HNP

A
  • widening of lateral foramen –> decreases intradiscal pressure
  • provided suction effect on disc material –> pulls it back into normal position
  • PLL also stretched –> pushes disc back into place
  • —> symptoms decrease in LE due to decreased compression on nerve root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Facet Impingement

A
  • manual techniques usually more effective
  • capsular impingement due to improper timing of contraction of multifidus or ligamentous dysfunction
  • mechanical block due to intra articular menisci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Facet Hypomobility

A
  • traction most effective when multisegment hypomobility is present
  • if one joint is hypo mobile, one of surrounding joints is HYPERmobile to maintain normal motion

argument against mechanical traction:
it is NON-SPECIFIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DDD/DJD

A
  • traction may reduce radicular signs and symptoms associated with nerve root compression from osteophyte formation
  • relief is NOT permanent
  • some have found traction to increase signs/symptoms =(
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Central Stenosis

A
  • pain is INCREASED with EXTENSION
  • sitting and FLEXION relieve leg pain
  • causes: arthritis, central disc bulge, hypertrophied ligament flavum
  • traction may decrease OR increase sx
  • -> monitor carefully through tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Contraindications

A
  • where motion is contraindicated:
    • fracture or dislocation
    • displacement of a fragment of annulus
    • cord compression
    • post recent abdominal or thoracic surgery
  • acute injury or inflammation (complete nerve block!)
  • patient cannot tolerate prone or supine positions
  • TMJ problems
  • claustrophobic patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of traction

A
  • manual: more specific to a segment, clinician can modify depending on pt response BUT difficult to determine amount of force being applied –> difficult to replicate and time and energy cost
    • used more in c spine than L spine
    • head in neutral : upper cervical
    • head in flexion (up to 30 degrees) : more distal lower c-spine

Should r/o vertebral aretery issues – no dizziness or blurry vision by extension and sidebend to test circle of willis

  • positional: ideal for localizing segment on one side, useful for stenosis or posterolateral disc herniation, may be done at home or concurrently with other modalities
  • mechanical (lumbar and cervical)
    • intermittent (chronic) or sustained (subacute)
    • prone or supine
    • split table (most beneficial)
  • bed traction: not used too much: high hospital cost, no research to support working better than bedrest alone
  • cottrell 90/90
    • posterior tilt
    • pt can pull rope from A-frame to lift pelvis increasing posterior tilt
      • good for lateral stenosis, not HNP
    • *not an AT thing
  • inversion boots/table: weight of body acts as traction force, cheap and easy to do at home BUT increases BP and pressure in eyes
  • home doorway
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lumbar Facet motion

A

FLEXION: bilateral facets upglide = OPEN

SB: ipsilateral facets downglide (CLOSE), contralateral upglide (OPEN)

ROTATION: ipsilateral facet joints gap (OPEN), contralateral facet joints approximate (CLOSE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

static or intermittent?

A

Cyriax: static
Maitland: static
Saunders: intermittent or static

  • static more popular in Europe

GENERAL RECOMMENDATIONS:

  • static when area inflamed or aggravated
  • intermittent with long hold times for disc protrusions
  • short hold and relax for joint dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lumbar Traction Position

A
  • supine is most common = promotes flexion (facet dysfunction, stenosis)
    • with hips/knees flexed –> posterior pull
    • with hips/knees neutral –> anterior pull
  • prone = promotes extension (disc problems)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lumbar Traction Force

A
  • 80-200lbs.
  • initially low
  • 1/2 body weight for a frictionless/split table (for nerve root or facet)
  • 25% body weight for soft tissue stretch
  • increase 5-15 lbs per session (no big jumps)
  • all the slack needs to be taken up before the split is released
  • patient must be able to relax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lumbar Traction Belts

A
  • directly on skin is best
  • pelvic belt just below iliac crests (at umbilicus)
  • then thoracic belt (at rib 8-10)
17
Q

Lumbar Traction Duration/Frequency

A
  • initial session: brief 5-10 min (assess tolerance)
  • typical: 20-30 min
  • QD to TIW, 6-12 tx
    (2 x a week, couple times a day)
18
Q

Cervical traction Types

A
  • Saunders frictionless halter (occiput)
  • fabric halters
  • over the door (easy)
19
Q

Cervical Traction Considerations

A
  • seated vs. supine (most common)

- may actually get joint compression if excessive muscle guarding

20
Q

Cervical Traction Position

A 
upper c-spine: neutral 0-5 deg
mid cerv (c2-5): 10-20 deg
* max separation at ~24 deg
lower cerv (c5-7): 25-35 degrees 
--> flattens lordosis 
--> opens posterior articulations 
---> widens intervertebral foramen, stretches posterior soft tissue
21
Q

Cervical Traction Force

A
  • begin low (8-10lb)
  • nerve root / facet: 20-30lb. (7% bw)
  • disc, soft tissue stretch: 12-15lbs.
  • increase 3-5 lbs / session
    • DO NOT exceed 2 x weight of head (30lb)
22
Q

Cervical Traction Dosage

A
  • Initial treatment less than 25 lbs
  • For HNP 60/10, 5-10 minutes
  • For joint or muscle 30/10, 10-15 minutes

**Be aware of TMJ – best to use Saunders cervical traction device

23
Q

Documentation of Tx

A 
Type of traction: Int or static
Treatment time
Patient position
Treatment parameters
Patient response

Modalities (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions