Transcript Lumbar Traction - Therapeutic Modalities

Lumbar Traction
Chapter 17
© 2005
Lumbar Traction
• Cervical vs. Lumbar
– Similar: separating the vertebrae
– Difference:
• Friction, muscle, soft tissue tension, and weight of the
lower extremity is a strong counterforce in lumbar
traction, requiring more tension to separate the vertebrae
– Force is approximately ½ the body weight
– Split table reduces friction
• Patient position has more influences on angle of pull in
lumbar traction
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General Uses
• INDICATIONS
• Spinal nerve
impingement
• Disk herniations
• Muscle spasm
• Radicular pain
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CONTRAINDICATIONS
Pain of unknown origin
Acute injury
Unstable spinal segments
Cancer, meningitis, or
other spinal cord/
vertebrae disease
• Vertebral fracture
• Extruded disk fragments
Patient Positioning
• Supine
– Increases flexion
• Supine + Flexion
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Further increasing flexion
46-60 = L5-S1
60-75 = L4-L5
75-90 = L3-L4
90 = Posterior intervertebral space
• Extension
– Opens facet joints and increases distraction in upper lumbar
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Patient Positioning
• Prone
– Used when excessive flexion or lying supine causes
pain
– Beneficial
• Allows other modalities to be used during traction
• Effects the lower disk protrusions
• Optimal Position
– Experience
– Trial and error
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Types of Lumbar Traction
• Inversion Traction
– Suspended upside
down
– Lengthens spine by
the weight of the
patient
– Hazardous
• Hypertension
• Cardiovascular
• Glaucoma
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• Gravitational Traction
– Patient Upright
• Can increase posterior disk
space between L1-S1
• Torso harness may be
uncomfortable
– Autotraction
• Support body weight by
hanging from a bar or arm
chair
• Relaxing spinal muscles
can distract vertebrae
Mechanical Traction Application
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Motorized lumbar traction
Assess body weight
Remove material that may interfere with halter
Adjust halter accordingly
– Traction halter = Pelvis
– Stabilization harness = 8th-10th Ribs
• Unlock split table and align target spinal segment over the
opening in the table
• Secure and connect halter
• Align angle of pull to correspond with specific pathology
• Explain treatment to patient and give safety switch
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Initiation of Treatment
• Set controls to zero and turn on unit
• Adjust ratio
• Tension
– Approximately 25% of body weight
– Radicular pain caused by disk herniation: 30 to
60% of body weight
• Duration
– Corresponding to pathology
•© 2005Instruct patient to remain relaxed
Termination of Treatment
• Tension
– Gradually reduce over 3 or 4 cycles
– Gain slack and turn unit OFF
– Many units have an auto OFF sequence
• Remove halter from unit and patient
• Patient remains in position for 5 minutes
after the treatment
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Manual Traction
• Helps determine the direction and amount
of force to apply mechanically
• In rare instances manual traction can be
substituted for mechanical traction
• Can be applied using a belt that allows the
clinician’s body weight to deliver the force
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