Mechanical Spinal Traction

Veronica Southard PT MS GCS

Spinal Traction

Electronic units Pulling forces Longitudinal separation and gliding C or L

segments or lengthening of soft tissues There are several types of traction including;

con’t bed traction, manual traction, Auto traction, Positional traction and Mechanical traction

Goal

Reduction of signs or symptoms of C or L spinal compression

Utilize maximal traction with minimal force

Physical Effects of Traction

Gentle stretch to joint capsule– Dependent upon the angle of pull and position of the

spinal segments

Effects Con’t

Increased inferior-superior dimensions of the intervertebral foramina

Elongation of posterior muscular tissues Improved blood supply to posterior soft tissue

and intervertebral discs Altered intradiscal pressure

Indications

Musculoskeletal signs:– Decreased sensation, motor function or reflexes,

that are temporarily reduced with manual traction– General hypomobility of spine– Local spinal hypomobility and associated increased

muscle tone that reduces with manual or positional traction

Indications con’t

Musculoskeletal symptoms:– Numbness of extremity, pain, tingling that is

temporarily relieved by manual or positional traction.– Central, unilateral or bilateral spinal pain reduced by

manual or positional traction

Common Indications

Spinal nerve root impingement due to DDD Intradiscal pressure if treatment is 10 minutes

or less. Spinal nerve root impingement due to stenosis.

Vertebral body separation, typically in a flexed direction

Generalized of hypomobility of L & C spine M spasm resulting in nerve root impingement

Contraindications

Absolute– 1. Spinal infections– 2. Spinal Ca– 3. Spinal Cord pressure– 4. RA– 5. Osteoporosis

Contraindications: Relative

Ligamentous strains and hypermobility Acute stage of injury Traction anxiety Cardiac or respiratory insufficiency Pregnancy

Patient instruction

Explain to patient Position Pt.

– C spine can be done in sitting or supine.Supine provides increased relaxation, vertebral separation and easier countertraction

– L traction can be done supine or prone

Angle of Pull

Angle of Pull– C spine Occiput ( C1-C2) 0-5 degrees flexion

Mid. Cervical (C2-C5) 10-20 flexion Low cervical (C5-C7) 25-30 flexion

Intervertebral Encroachment

Flex, and SB toward unaffected side and rotation toward affected side

Disc- C spine neutral. Want ligaments to be lax and allow better distraction

Lumbar spine

Positioning for intervertebral encroachment is neutral for bilateral involvement. Unilateral SB toward good side with trunk rotated toward the affected side.

Facets are treated in flexion Position: L5-S1= 45* hip flexion

L4-L5 = 60-75* HIP FLEXION L3-l4 + 75-90* HIP FLEXION

Traction Technique

Angle of pull– C spine supine better. 25* flexion– L spine Flex hip and knees, symmetrical or prone or

unilateral technique

Force

C spine start with 15#, Increase to 25#, Never exceed 50#

L spine 25% body weight, up to 50% body weight. Never exceed body weight. Nerve root problems may require only 25-60#. Start with low force

Mode of treatment

Intermittent Most comfortable– On times generally between 7-20 sec– Off times 7 to 60 sec– On/Off ratio may be 1:1 or 3:1

Static traction

Used less frequently. Treatment times 8-25 minutes Brief continuous for disc problems 10 minutes Facet problems 15-20 minutes

Other duration considerations

HNP Decrease time 5-8 minutes DJD, Spondylolithesis up to 20’ Frequency from 2-3 times per week up to daily Allow the patient to rest a few minutes upon

completion. Ask the patient f they have any dizziness or headache post treatment

Document

A. Position B. Angle of pull C. Amount of force., hold and rest cycles D. Static or intermittent E. Duration F. Pt. Response

– Pain / changes– Functional changes