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Traction: Cervical & Lumbar

This document discusses cervical and lumbar traction, including indications such as herniated discs and muscle spasms, contraindications like fractures, and techniques for proper positioning and application of traction. Both cervical and lumbar traction are described in detail, outlining how they work to apply longitudinal force to decompress the spine through widening of intervertebral spaces. Precautions and treatment set-up are also reviewed.

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Boud Elhassan
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© © All Rights Reserved
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Download as PPT, PDF, TXT or read online on Scribd
389 views

Traction: Cervical & Lumbar

This document discusses cervical and lumbar traction, including indications such as herniated discs and muscle spasms, contraindications like fractures, and techniques for proper positioning and application of traction. Both cervical and lumbar traction are described in detail, outlining how they work to apply longitudinal force to decompress the spine through widening of intervertebral spaces. Precautions and treatment set-up are also reviewed.

Uploaded by

Boud Elhassan
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Traction

Cervical & Lumbar


Traction
 Application of a longitudinal force to the spine &
associated structure

 Can be applied with continuous or intermittent


tension
 Continuous – small force for extended time (over hours)
 Sustained - small force for extended time (45 min. or
less)
 Intermittent – alternates periods of traction & relaxation
(most common)

 May be applied manually or with a mechanical


device
Indications
 Muscle spasm
 Certain degenerative disk diseases
 Herniated or protruding disks
 Nerve root compression
 Facet joint pathology
 Osteoarthritis
 Capsulitis of vertebral joints
 Anterior/posterior longitudinal ligament
pathology
Cervical
Disc
Herniation
Lumbar
Disc
Herniation
Contraindications
 Unstable spine
 Diseases affecting vertebra or spinal cord,
including cancer & meningitis
 Vertebral fractures
 Extruded disk fragmentation
 Spinal cord compression
 Conditions in which flex. &/or ext. are
contraindicated
 Osteoporosis
Precautions
 Condition should have been
evaluated by a physician
 Physician’s Orders
 Close monitoring of patient should
be performed throughout treatment
 Can cause thrombosis of internal
jugular vein if excessive duration or
traction weight is used
Cervical Traction
 Application of a longitudinal force to the C-
spine & structures
 Tension applied can be expressed in
pounds or % of patient’s body weight.
 At 7% of patient’s body weight, vertebral
separation begins
 Human head accounts for 8.1% of body
weight (8-14 lbs.)
 Greater amount of force is needed widen areas
 You want force to be about 20% of body
weight
Cervical Traction Positioning
 Seated – a greater force is needed
to apply the same pressure (due to
gravity) than if supine

 Supine – support lumbar region (bend


knees, use knee elevator, or hang lower legs
over end of table & place feet on chair); allows
musculature to relax
Effects of Cervical Traction
 Reduces pain & paresthesia
associated w/ n. root
impingement & m. spasm

 Reduces amount of pressure on


n. roots & allows separation of
vertebrae to result in
decompression of disks.
Effectiveness of Cervical
Traction
 Cervical traction has been linked to
5 mechanical factors
 Position of the neck
 Force of applied traction

 Duration of traction

 Angle of pull

 Position of patient
Cervical Treatment Set-up
 Neck – placed in 25-30° flexion
 Straightens normal lordosis of C-spine
 Must have at least 15° flexion to separate facet joint
surfaces
 Body must be in straight alignment
 Be aware that C-spine traction can
cause residual lumbar n. root pain
if improperly set up.
 Duration – 10-20 minutes most
common
Cervical Treatment Set-up
 Remove any jewelry, glasses, or clothing
that may interfere
 Lay supine, place pillows, etc. under
knees
 Secure halter to cervical region placing
pressure on occipital process & chin
(minor amount)
 Align unit for 25-30° of neck flexion
 Remove any slack in pulley cable
 On:Off sequence 3:1 or 4:1 ratio
Cervical Treatment
 Following treatment, gradually
reduce tension & gain slack
 Have patient remain in position for a
few minutes after treatment
Lumbar Traction
 To be effective, lumbar traction must
overcome lower extremity weight
(¼-½ of body weight)

 Friction is a strong counterforce


against lumbar traction
 Split table is used to reduce friction
Lumbar Traction
 Mechanical traction
 Motorized unit
 Self-administered
Autotraction
 Manual traction
 Belt
• Thoracic
stabilization harness
• Pelvic traction
harness
 Clinician’s body
weight
Lumbar Traction
 Tension
 Approximately ½ of body weight
 Published literature = 10-300% of patient’s
body weight
 Patient Position & Angle of Pull
 Should maximize separation & elongation of
target tissues
 Prone or Supine – depends on:
• Patient comfort
• Pathology
• Spinal segments & structures being treated
Lumbar Traction - Patient Position
 Supine positioning
• Tends to increase lumbar flexion
• Flexing hips from 45 to 60 increases laxity in L5-S1
segments
• Flexing hips from 60 to 75 increases laxity in L4-L5
segments
• Flexing hips from 75 to 90 increases laxity in L3-L4
segments
• Flexing hips to 90 increases posterior intervertebral
space
 Prone Position
• Used when excessive flexion of lumbar spine & pelvis
or lying supine causes pain or increases peripheral
symptoms
Lumbar Traction – Angle of Pull
 Anterior angle of pull increases amount of
lumbar lordosis
 Posterior angle of pull increases lumbar
kyphosis
 Too much flexion can impinge on the posterior
spinal ligaments
 Optimal position & angle of pull –
 Often derived by trial & error
 Depends on patient & pathology of injury
Lumbar Treatment Set-up
 Calculate body weight
 Apply traction & stabilization harness
 Position on table, drape for modesty
 Set mode – intermittent or continuous
 Set ON:OFF ratio time
 Set tension
 Set duration
 Give patient Alarm/Safety switch
 Explain everything to patient prior to
beginning treatment!
References
 Google Images
 www.wheelessonline.com/
ortho/cervical_disc_he...
 mri.co.nz/ medimgs/Muscu.htm

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