Spinal Traction

Question 1

traction definition and use

Answer 1

Use of traction forces applied to the cervical and lumbar spine via external mechanical systems
• Use for cervical and back pain disorders

Elongates spine & increases inter-vertebral spaces.

Question 2

Proposed physiological effects of traction (5)

Answer 2

• Spinal elongation
• Widens inter-vertebral foramen
• Stretches ligament, muscles, facet joints
• Decreases pain*
• Enhances spinal mobility*
*Results from reduced nerve root compression, release of adhesions around the vertebral joints & decrease in muscle spasm.

Question 3

Potential Indications for Traction (2); _____ secondary to what 5 things?

Answer 3

• Spine degenerative joint disease
• Radiculopathy secondary to: 
 HNP (herniated nucleus pulposis)
Narrowing of inter-vertebral foramen Osteophyte encroachment Ligament encroachment
 Spondylolisthesis

Question 4

Contraindications to spinal traction (13)

Answer 4

• Vertebral fracture
• Osteoporosis
• Disease, infections or tumors affecting spine
• Severe disc herniation including displaced disc
• Rheumatoid arthritis
• Vertebral artery & TMJ dysfunction (cervical traction only)
• Peripheralization or increase pain
• Aortic aneurysm • Spinal
instability/hypermobility
• Spinal cord compression • Hernia (hiatal/abdominal) • Down syndrome
• Pregnancy (lumbar traction)

Question 5

precautions for mechanical spinal traction (9)

Answer 5

• Acute spinal condition
• Internal jugular vein
thrombosis
• Patients unable to tolerate prone/supine position
• History of spine surgery
• HTN (inverse traction only)
• Patients with respiratory & hypertensive disorders
• Patients with dentures (use occipital halter only)
• Patients with breathing problems (lumbar traction)
• TMJ problems (only for cervical traction)

Question 6

what are the four ways spinal traction can be delivered

Answer 6

motorized tables
pneumatic
weights
manual traction

Question 7

see slides 11 and 12 for tables for types of spinal traction

Answer 7

both most common and less common

Question 8

What mode is most effective for spinal traction

Answer 8

no evidence shows one is better than the other

Question 9

what is static traction? what is it indicated for (3)?

Answer 9

• Continuous application at a fixed traction force for the entire treatment session.
• Indicated for: • Disc
protrusion/herniation.
• If symptoms are easily aggravated by motion.
• Sub-acute inflammation

Question 10

What is intermittent traction? How long do hold and relax cycles run from?

Answer 10

• Alternating application of Hold and Relax cycles between minimum and maximum force ranges.
• Hold/ Relax cycles can run from 5- 60 secs each
• Repeats throughout treatment session.

Question 11

Symmetric central traction force are used to

Answer 11

force directly in line with patient’s long axis of spine

Question 12

off axial traction force are used to

Answer 12

Offsets the axis of traction pull to provide lateral flexion

Question 13

Force needed for cervical traction treatment

Answer 13

weight of the head (about 8.3% of body weight)

Question 14

what position is the patient in during cervical traction

Answer 14

Hooklying: Place neck in 0°-30° of flexion

if a sitting position is utilized a greater force is needed due to effects of gravity

Question 15

force needed for lumbar traction

Answer 15

weight of the pelvis and hips is about 30% of a person’s body weight - traction force must be 30-60% of body weight

Question 16

Positioning for lumbar traction treatment

Answer 16

• Supine with hips flexed at 90° to increases posterior inter-vertebral space
• Prone is used when lying supine or excessive flexion of lumbar-spine causes pain or further peripherilization of symptoms.

Question 17

how long/often should traction be utilized

Answer 17

• 10-30 minutes daily or every other day pending patient’s response and therapeutic progress

Question 18

suggested progression for cervical traction

Answer 18

Increase force by 3-5 lbs per treatment session

Question 19

suggested progression for lumbar traction

Answer 19

Can increase by 5-15 lbs each treatment session