Clinical Research


The Management of a Patient with a Cervical Disc Herniation: A Case Report
By Sherry Tsao and Peter Pidcoe
Department of Physical Therapy, Virginia Commonwealth University—Medical College of Virginia, Richmond, VA 23298.

Summary: To present the management of a patient with a cervical disc herniation and illustrate the efficacy of cervical traction as a main form of treatment for cervical disc herniation in conjunction with a home exercise program.

Conclusion: Cervical traction and a good home exercise program have been shown to reduce cervical disc herniation and its subsequent symptoms.

Spinal Decompression
By Thomas A. Gionis, MD, JD, MBA, MHA, FICS, FRCS, and Eric Groteke, DC, CCIC

Summary: The outcome of a clinical study evaluating the effect of nonsurgical intervention on symptoms of spine patients with herniated and degenerative disc disease is presented.

Conclusion: In conclusion, nonsurgical spinal decompression provides a method for physicians to properly apply and direct the decompressive force necessary to effectively treat discogenic disease. With the biotechnological advances of spinal decompression, symptoms were restored by subjective report in 86% of patients previously thought to be surgical candidates and mechanical function was restored in 92% using objective data.


Efficacy of Lumbar Traction
By GJMG van der Heijden, AJMH Beurskens, MJM Dirx, LM Bouter, and E Lindeman

Summary: A pilot study for randomized clinical trial compares the effect of high-dose continuous lumbar traction and low-dose continuous lumbar traction on the magnitude and rate of recovery with patient for low back pain.

Conclusion: 34% of the control group and 64% in the treatment group reported that they had completely recovered or were much improved.


Intermittent Cervical Traction and Thoracic Manipulation
By Browder DA, Erhard RE, Piva SR

Summary: Seven women with neck pain, 35 to 45 years of age, were identified as having signs and symptoms consistent with grade 1 cervical compressive myelopathy. Symptom duration ranged from less than 1 week to 52 weeks. All patients were treated with intermittent cervical traction and thoracic manipulation for a median of 9 sessions over a median of 56 days.

Conclusion: Intermittent cervical traction and manipulation of the thoracic spine seem useful for the reduction of pain scores and level of disability in patients with mild cervical compressive myelopathy attributed to herniated disc.


A Clinical Prediction Rule for Classifying Patients With Low Back Pain Who Demonstrate Short-Term Improvement With Mechanical Lumbar Traction
By Congcong Cai, Yong Hao Pua, Kian Chong Lim

Summary: The objective of the study was to develop a clinical prediction rule for identifying patients with low back pain, who improved with mechanical lumbar traction. A prospective, cohort study was conducted in a physiotherapy clinic at a local hospital. Patients with low back pain, referred to physiotherapy were included in the study. The intervention was a standardized mechanical lumbar traction program, which comprised three sessions provided within 9 days.

Conclusion: Four predictors were identified for predicting short-term responders to mechanical lumbar traction. Based on the prediction model in this study, possession of all 4 predictors suggested increased probability of successful treatment. This CPR may significantly enhance the efficacy of clinical decision-making when considering mechanical lumbar traction as an appropriate intervention for patients with LBP.