Vertical traction for lumbar radiculopathy: a systematic review

Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis

Objective

This study is aimed at exploring the clinical effect of mechanical traction on lumbar disc herniation (LDH).

Methods

Related literatures were retrieved from PubMed, Medline, Embase, CENTRAL, and CNKI databases. Inclusion of literature topic was comparison of mechanical traction and conventional physical therapy for lumbar disc herniation. Jadad scale was used to evaluate the quality of the included RCT studies. The Chi-square test was used for the heterogeneity test, and a random effect model was used with heterogeneity. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. If there was no heterogeneity, the fixed effect model was used, and funnel plots were used to test publication bias.

Results

Visual analog scale (VAS) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = −1.39 (95% CI (-1.81, -0.98)), Z = 6.56, and P < 0.00001). There was no heterogeneity among studies (Chi² = 6.62, P = 0.25, and I² = 24%) and no publication bias. Oswestry disability index (ODI) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = −6.34 (95% CI (-10.28, -2.39)), Z = 3.15, and P = 0.002). There was no heterogeneity between studies (Chi² = 6.27, P = 0.18, and I² = 36%) and no publication bias. There was no significant difference in Schober test scores between the mechanical traction group and the conventional physical therapy group (MD = −0.40 (95% CI (-1.07, 0.28)), Z = 1.16, and P = 0.25). There was no heterogeneity among studies (Chi² = 1.61, P = 0.66, and I² = 0%) and no publication bias.

Conclusion

Mechanical traction can effectively relieve lumbar and leg pain and improve ODI in patients with lumbar disc herniation but has no significant effect on spinal motion. The therapeutic effect of mechanical traction was significantly better than that of conventional physical therapy. Lumbar traction can be used in conjunction with other traditional physical therapy.

Inversion Table Fall Injury, the Phantom Menace: Three Case Reports on Cervical Spinal Cord Injury

Background: An inversion device, which is used to suspend one’s body and perform traction therapy, was introduced as an inversion table under the name of “Geokkuri” in South Korea. Fall injuries while hanging on inversion tables are among the most devastating spine injuries, as the likelihood of severe neurological sequelae such as tetraplegia increases. However, its enormous danger has been overlooked and this devastating injury has become a common clinical entity over time. The limited number of studies reported imply the lack of interest of researchers in these injuries. We reviewed three cases of spinal cord injury sustained on inversion tables in different environments and report the potential danger associated with the use of inversion tables to facilitate a safer exercise environment.