spinal traction overview chapter 17. purpose force that separates the vertebrae, opening the...
TRANSCRIPT
![Page 1: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/1.jpg)
Spinal TractionOverview
Chapter 17
![Page 2: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/2.jpg)
Purpose
• Force that separates the vertebrae, opening the intervertebral space
• Effects:– Decreased pressure on intervertebral disks
– Decreased pressure spinal nerve rots
– Opens facet joints
– Elongates tissue
• Body areas:– Cervical
– Lumbar/pelvis
![Page 3: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/3.jpg)
Types of Traction
• Sustained– Continuous, small force for an extended period
(appx. 45 min)
• Intermittent– Alternately applied and withdrawn traction
• Manual– Administered by the clinician
• Positional– Body positioning to elongate the involved tissue
![Page 4: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/4.jpg)
General Principles• Angle of pull
– Neutral: Transverse plane– Flexion/Extension: Frontal plane– Unilateral: Sagittal plane– Multiaxial: Two or more planes
• Anatomical differences– Cervical inferior facet joints angle anteriorly
• Flexion opens facet joints
– Lumbar facets angled posteriorly• Extension opens facet joints
![Page 5: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/5.jpg)
General Principles
• Tension– No clear formula– The traction must overcome the resistance exerted
by the soft tissue– Use the least amount of tension needed to relieve
symptoms– Duration is inversely related to tension
![Page 6: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/6.jpg)
Physiological Effects
• Encourages movement of spine between each vertebra• Improves circulation• Increases metabolism• Enhances nutrition • ROM increases dependent on:
– Patient position
– Amount of force applied
– Type of traction
– Treatment time
![Page 7: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/7.jpg)
Indications
• Disk protrusions
• Degenerative disk disease
• Nerve root compression
• Facet joint pathology
• Muscle spasm
![Page 8: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/8.jpg)
Contraindications
• Acute injury
• Unstable spinal segments
• Cancer, meningitis, or other spinal cord/ vertebrae disease
• Vertebral fracture
• Extruded disk fragments
![Page 9: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/9.jpg)
Intervertebral Disks and Disk Lesions
• Anatomy– Annulus fibrosus
– Nucleus pulposus
• Dehydration– Decrease range of motion narrowing intervertebral
foramen
– Weakens annulus fibrosis
– Day vs. night
– Age
![Page 10: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/10.jpg)
Disk protrusion
• Body weight and muscle tone compress the disk and force the nucleus pulposus posteriorly
• Traction – Decreases the pressure
– Increases disk hydration
• Imbibe– Traction applied for too long can absorb too much fluid
![Page 11: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/11.jpg)
• Anatomy:– Intervertebral foramen:
– Opening for 31 pairs of spinal nerve roots
• Disk degeneration– Narrowing of intervertebral space
• Osteophytes– Decrease opening
– Inflammation of nerve sheath’s
Intervertebral Foramen Stenosis
![Page 12: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/12.jpg)
Facet Joint Pathology
• Healthy facets transmit approximately 20% of the body weight
• Inflamed facets transmit approximately 47% of body weight (lumbar spine)
• Traction can open the facet joints
![Page 13: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/13.jpg)
Muscle Spasm
• Long, slow stretching can reduce tonic muscle contraction by elongating the involved fibers
• Intermittent traction promotes relaxation during the OFF phase
• Increased diameter of the intervertebral foramen decreases muscle spasm– Reduced pressure on spinal nerve roots
![Page 14: Spinal Traction Overview Chapter 17. Purpose Force that separates the vertebrae, opening the intervertebral space Effects: –Decreased pressure on intervertebral](https://reader036.vdocuments.net/reader036/viewer/2022083006/56649f355503460f94c52c6e/html5/thumbnails/14.jpg)
Maintenance
• Cleaning – Follow manufacturer’s instructions for unit and
harness– Avoid liquids from entering unit
• Check cords and traction cable
• Recalibrate unit
• Unit must be inspected and serveced by a technician annually