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Spinal Decompression

FDA cleared indications

  • Pain relief related to
    • Protruding and herniating discs
    • Degenerative disc disease (DDD)
    • Facet joint disorders
    • Spinal root impingement
    • Degenerative joint disease (DJD)
    • Hypomobility
    • Compression fractures

Back and Neck Pain – Causes

  • Back and neck pain is related to different causes
    • Active support system failure (muscle strain/injury)
    • Structural support system failure (Ligament, disc injury)
    • Chronic conditions usually have failure of both systems: structural damage and muscle imbalance

Goals of Mechanical Decompression

  • Mechanical effects
    • Stretch ligaments, muscles
    • Relax musculature
    • Decrease intradiscal pressure
    • Widen intervertebral foramen
  • Physiological effects
    • Relief nerve root compression
    • Possible disc retraction
    • Mobilize joint and muscle
    • Improve blood flow
    • Decrease pain

Patient Selection

  • Radiating pain in dermatomal distribution
    • With or without sensory loss
    • With or without decreased strength in key muscles
  • Decreased ROM in capsular pattern of restrictions
    • With or without radiculopathy
    • No exacerbation of pain after "trial" of manual traction
    • With or without degenerative spondylotic changes
  • Centralization of the pain after "trail" of manual traction is indicator of favorable outcomes of mechanical traction.

Expected Outcomes of Decompression

  • Symptomatic relief
    • Decreased back pain
    • Increased ROM
    • Decreased muscle tone
  • Functional improvement
    • Increased participation in exercise
    • Increased work tolerance
    • Increased participation in ADLs
  • Red flags
    • Pain increases or starts referring
    • Muscle guarding increases

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