Spinal Traction (wk 4) Flashcards
What are the goals for spinal traction? (7)
To decrease:
- Joint stiffness (hypomobility)
- Meniscoid blocking
- Muscle spasm
- Disc protrusion
- Discogenic pain
- Joint pain
- Nerve root impingement
What are the general indications for spinal traction? (2)
- Cervical or lumbar spine pain with radiculopathy
2. Patients who have reduction of symptoms with manual traction
Contraindication or precaution of spinal traction:
Claustrophobia
precaution
Contraindication or precaution of spinal traction:
acute strains, sprains, and inflammation
Contraindication
Contraindication or precaution of spinal traction:
Hiatal hernia
precaution
Contraindication or precaution of spinal traction:
spondylolisthesis
Contraindication
Contraindication or precaution of spinal traction:
fractures
Contraindication
Contraindication or precaution of spinal traction:
increase peripheralization with traction
Contraindication
Contraindication or precaution of spinal traction:
increase nerve root symptoms with traction
Contraindication
Contraindication or precaution of spinal traction:
Impaired cognition
precaution
Contraindication or precaution of spinal traction:
joint hypermobility or instability
Contraindication
Contraindication or precaution of spinal traction:
Any disease or condition that can compromise the structure of the spine (RA, prolonged steroid use, tumor, osteoporosis, etc.)
precaution
Contraindication or precaution of spinal traction:
pregnancy (lumbar traction)
Contraindication
Contraindication or precaution of spinal traction:
patients who have received surgical stabilization or decompression, spine implants, or prosthetic disks
Contraindication
Joint distraction, the separation of the facet joints occurs with sufficient force, does what two things to the intervertebral foramen?
- Relieves pressure on nerve root
2. Decreases compressive forces on facets
What type of joint distraction traction forces recommended for initial treatment?
Lower traction forces
Describe the use of traction to reduce disc protrusion:
- Separate vert bodies at higher force -> decrease intradiscal pressure creating suction like effect on nucleus potentially drawing it back in centrally
- Surrounding ligamentous structures taut which also helps push disc in centrally
What % of body weight or lbs results in cervical region joint distraction?
7% of body weight or about 20-30lbs results in separation
Minimum of what % of body weight results in lumbar region joint distraction?
min of 50% of patient’s body weight
Reduction of disc protrusion with traction of the lumbar region requires what % of patients body weigh
up to 50%
Reduction of disc protrusion, soft tissue stretching, and muscle relaxation of the cervical region requires how many lbs?
12-15 lbs
soft-tissue stretching and muscle relaxation by traction of the lumbar region requires what % of body weight?
25%
Soft-tissue stretching of the surrounding spinal muscles, ligaments, tendons, and discs can be stretched with the goal of what?
Decreasing pressure on facets, nerve roots, vertebral bodies and discs without achieving joint separation
Describe effect of intermittent traction and static traction on muscle relaxation:
intermittent traction - interrupt the pain-muscle spasm cycle by stimulating mechanoreceptors
static traction - inhibiting neuron firing
targeting what region with greater the cervical flexion
lower cervical area
T/F Cervical traction generally recommended not to exceed 30-40 lbs and to start light
True
In the acute phase of cervical traction, how much weight applied for these goals:
- Disc protrusion, elongation of soft tissue, muscle spasm -
- Joint distraction -
- Disc protrusion, elongation of soft tissue, muscle spasm - 10-15 lbs
- Joint distraction - 20-30 lbs
5-10 minutes of cervical traction for what 2 conditions?
- acute
2. disc protrusions
If your there is disc protrusions or symptoms aggravated with motion in cervical region, what type of traction do you use? (duty cycle)
Static
What is the expert opinion about hold/rest ratio of intermittent traction for cervical region:
disc protrusion -
joint distraction/mobility -
disc protrusion - 3:1 hold/rest
joint distraction/mobility - 1:1 hold/rest
Post traction you must watch for what?
rebound effect - have patient relax for 5 minutes after treatment (can spasm if not)
What are positive outcomes you record post traction?
- ↓ symptoms
- Centralization of symptoms
- ↑ ROM/strength
- Improved ability to perform ADLs
- Improved reflexes/sensation
T/F Research shows that after traction mean area of disc herniation was reduced & disc space increased.
true
T/F over-the-door traction showed equal improvements to scores on neck disability, neck pain intensity, and arm pain intensity as mechanical traction
False, patients who underwent mechanical traction reported lower scores on neck disability, neck pain intensity, and arm pain intensity
For lumbar spine traction, what vert are you focusing on when hip flexion:
45-60 hip flexion =
75-90 hip flexion =
Closer to L1
45-60 hip flexion = L5/S1
75-90 hip flexion = upper lumbar region
How to apply thoracic harness for mechanical traction? Lower harness?
- Placed inferior to the widest lateral dimension of the rib cage (Two straps that will be attached to the end of the table)
- At or just below the iliac crests but superior to the greater trochanters (Two straps that will attach to a metal V shapes rod that then attaches to the mechanical unit)
Lumbar traction force for:
acute phase = lbs
disc protrusion, spasm, elongation of soft tissue = %
joint distraction = %
acute phase = 30-40 lbs (less force)
disc protrusion, spasm, elongation of soft tissue = 25% of body weight
joint distraction = 50% of body wieght
Treatment time for lumbar traction force for:
Herniated disc =
Other conditions =
Herniated disc = 5-10 min
Other conditions = 10-30 min
T/F Substantially greater reduction of the total area of herniated disc material with lumbar traction vs. use of “other modalities”.
True
How can you improve lumbar traction when used with 30 & 60% of body weight?
Straight leg raise
T/F Traction can be used alone for the best possible outcomes.
False, traction should be combined with other interventions
Describe the home traction unit for cervical region:
- Pneumatic pump with gauge quantifying tension
- Adjustable headrest, similar positioning
- Sustained traction
Describe the home traction unit for lumbar region:
- Pneumatic pump, harness to stabilize
- Less tension produced than clinical unit
- Positioning on floor required
