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Distraction Techniques for Lumbar Pain
Practical Pain Management, 3/2003 Alan Ottenstein, M.D.
"At the dawn of the 21st century there are still a great many patients still suffering from common lumbar pain syndromes."
"Some patients do not wish to take any medication whatsoever, while other patients may wish to use medications exclusively and not consider any other therapy. Still other patients will wish to have whatever therapy is available, no matter how aggressive and risky the treatment may, be as soon as possible."
"Surgery is not the panacea for most spinal problems. We now understand that there are great limitations to what surgery can accomplish."
"Over the past decade a new procedure category has arisen: that of interventional but non-invasive therapy. Fortunately for today's patients, therapies in this class actively intervene in the disease process and help to bring about improvement in the patient's symptoms, and the disease itself, but do so without penetrating the patient's body. The most useful of these, and the most widely used at present, are the lumbar distraction techniques."
The first lumbar distraction technology was one the employed a prone (face down) patient position. This was developed in 1991. Despite a significant incidence of side effects, the procedure became popular in the United States and Canada simply because it could do what no other procedure had been able to do before. The problems inherent with this older technology were:
- The force was too general, therefore, it lacked the ability to specifically treat a vertebral level
- This device required patient cooperation to relax the muscles of the low back region
- Patients were required to maintain contraction of shoulder girdle and neck muscles for treatment periods that were about 30 minutes in duration
A team of neurosurgeons, orthopedic surgeons and other physicians developed a more comfortable device in the late 1990's. This improved computerized lumbar distraction device had the advantages of the previous device while remedying its problems. This device is called the DRS (distraction, reduction, stabilization - AKA computerized spinal decompression or CSD) gained clearance for use in the United States in January of 1998. Early experience with the DRS has shown that it is superior to the prone therapy with decreased complications."What the DRS device with IDD Therapy does is create and focus a distraction force at a given level of the lumbar spine through adjustment of the applied forces. The patient undergoing this treatment does not need to do anything to cooperate with the treatment other than relax."
Edward L. Eyerman, M.D. wrote that DRS mechanical decompression distraction provided not only symptomatic improvement in patients with lumbar pain syndromes, but also created improvement in MRI findings from pre-treatment to post-treatment.
"Herniation of the disk was reduced, disk height was increased and the disk was rehydrated after only 11 sessions during a 7-week period."
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