Literature DB >> 20615252

Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.

Christian C Apfel1, Ozlem S Cakmakkaya, William Martin, Charlotte Richmond, Alex Macario, Elizabeth George, Maximilian Schaefer, Joseph V Pergolizzi.   

Abstract

BACKGROUND: Because previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP) due to disc degeneration (discogenic low back pain) and disc herniation, it has accordingly been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration. The goal of this study was to determine if changes in LBP, as measured on a verbal rating scale, before and after a 6-week treatment period with non-surgical spinal decompression, correlate with changes in lumbar disc height, as measured on computed tomography (CT) scans.
METHODS: A retrospective cohort study of adults with chronic LBP attributed to disc herniation and/or discogenic LBP who underwent a 6-week treatment protocol of motorized non-surgical spinal decompression via the DRX9000 with CT scans before and after treatment. The main outcomes were changes in pain as measured on a verbal rating scale from 0 to 10 during a flexion-extension range of motion evaluation and changes in disc height as measured on CT scans. Paired t-test or linear regression was used as appropriate with p < 0.05 considered to be statistically significant.
RESULTS: We identified 30 patients with lumbar disc herniation with an average age of 65 years, body mass index of 29 kg/m2, 21 females and 9 males, and an average duration of LBP of 12.5 weeks. During treatment, low back pain decreased from 6.2 (SD 2.2) to 1.6 (2.3, p < 0.001) and disc height increased from 7.5 (1.7) mm to 8.8 (1.7) mm (p < 0.001). Increase in disc height and reduction in pain were significantly correlated (r = 0.36, p = 0.044).
CONCLUSIONS: Non-surgical spinal decompression was associated with a reduction in pain and an increase in disc height. The correlation of these variables suggests that pain reduction may be mediated, at least in part, through a restoration of disc height. A randomized controlled trial is needed to confirm these promising results. CLINICAL TRIAL REGISTRATION NUMBER: NCT00828880.

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Year:  2010        PMID: 20615252      PMCID: PMC2912793          DOI: 10.1186/1471-2474-11-155

Source DB:  PubMed          Journal:  BMC Musculoskelet Disord        ISSN: 1471-2474            Impact factor:   2.362


  18 in total

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2.  Lumbar disk herniation: MR imaging assessment of natural history in patients treated without surgery.

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Review 3.  Technology Insight: imaging of low back pain.

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Authors:  Alex Macario; Joseph V Pergolizzi
Journal:  Pain Pract       Date:  2006-09       Impact factor: 3.183

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8.  Computed tomography-evaluated features of spinal degeneration: prevalence, intercorrelation, and association with self-reported low back pain.

Authors:  Leonid Kalichman; David H Kim; Ling Li; Ali Guermazi; David J Hunter
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9.  Treatment of 94 outpatients with chronic discogenic low back pain with the DRX9000: a retrospective chart review.

Authors:  Alex Macario; Charlotte Richmond; Martin Auster; Joseph V Pergolizzi
Journal:  Pain Pract       Date:  2008 Jan-Feb       Impact factor: 3.183

Review 10.  Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.

Authors:  Roger Chou; Laurie Hoyt Huffman
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  12 in total

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Review 4.  Extracellular Vesicles as an Emerging Treatment Option for Intervertebral Disc Degeneration: Therapeutic Potential, Translational Pathways, and Regulatory Considerations.

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6.  Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial.

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Review 7.  Emerging Issues Questioning the Current Treatment Strategies for Lumbar Disc Herniation.

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8.  Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk.

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9.  Clinical research for whether the Traditional Chinese medicine could promote the resorption of lumbar disc herniation: a randomized controlled trial.

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10.  Nonsurgical spinal decompression system traction combined with electroacupuncture in the treatment of multi-segmental cervical disc herniation: A case report.

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