home  |  Temecula Valley  | Coachella Valley   |  NCC San Diego   |  Riverside-Corona  |  Chicago |  Hong Kong   |  franchise
            
Click a category above or search for a topic:
 

Spinal Decompression: Quo vadis?

By Lee Hazen, DC

 Disc disease, the most common cause of back pain, is the most expensive benign condition that is medically treated in industrial countries and costs the American health care system more than $50 billion annually.  It is also the number one cause of disability in persons under age 45. After 45, it is the third leading cause of disability.

With the recent advances in biotechnology, spinal decompression has evolved into a cost-effective non-surgical treatment for herniated and degenerative spinal disc disease. It works on the affected spinal segment by significantly reducing disc pressure.

People often ask what happens to the spine to create the need for treatment. Here is a peek.  The alteration of normal spinal movement is the most prevalent cause of lower back pain and disc disruption and thus it is vital to maintain proper spinal alignment and movement in and around the spinal disc.

 Researchers have correlated disc degeneration to clinical symptoms. The three clinical stages of spinal degeneration include:
 
Stage of Dysfunction. There is little pathology and symptoms are subtle or absent. Misalignment may exist. The diagnosis of back strain is commonly used.
 
Stage of Instability. Abnormal movement of the disc and vertebra exists and the patient complains of moderate symptoms with objective findings. Conservative care is used and rarely surgery is indicated.
 
Stage of Stabilization. The third phase where there are severe degenerative changes of the disc and vertebral joints (arthritis) reduce motion with likely stenosis.
 
Biotechnological advances have fostered the design of many Food and Drug Administration-approved ergonomic devices that decompress the intervertebral discs.

Question: Do all the decompression tables do the same thing?  Answer: Not at all.
 
Devices that decompress the intervertebral discs began with Cox flexion distraction manipulation in the 1970's. The decompression works by decompression at the specific disc level that is diagnosed from finding on physical examination and the appropriate diagnostic imaging studies. The angle of decompression to the affected disc level causes a negative pressure intradiscally that creates an osmotic pressure gradient for nutrients, water, and blood to flow into the degenerated and/or herniated disc thereby allowing the phases of healing to take place.

A study by researchers reported the positive effects of distraction on the disc with contour changes (reduced disc bulging) by CT scan.
 
 Traditional medical traction has proven to be less effective and biomechanically inadequate to produce optimal therapeutic results. In fact, one study concluded that any benefit derived from continuous traction devices was due to enforced immobilization rather than actual traction. Patients treated with traction vs. a control group that had simulated traction demonstrated no significant differences!
 
Some decompression tables are "push and play" unattended traction where no direct doctor involvement nor specific area of the spine is decompressed. These may be less effective.
 
Instead, hands on chiropractic spinal decompression (Cox technique), that is, unloading due to flexion distraction and positioning of the intervertebral discs and facet joints of the lumbar spine, has been proven an effective treatment for herniated and degenerative disc disease, by producing and sustaining less pressure in the disc space. The degenerated disc may benefit by lowering intradiscal pressure, affecting the spine for nutrients, water, and blood to flow into the degenerated and/or herniated disc thereby allowing the phases of healing to take place.
 
The cost for decompression  therapy varies from office to office which is often more a reflection of the office overhead than the effectiveness of the device used. Nevertheless this less successful non-surgical therapy is less than a tenth of that for surgery.
 
In conclusion, non-surgical clinical outcomes studies, which are performed to evaluate the effect of spinal decompression on symptoms of patients with herniated and degenerative disc disease, show that 86% of patients who completed therapy reported resolution of symptoms, and 84% of those remained pain-free 90 days post-treatment.

Physical examination findings revealed improvement in 92% of the patients who completed this form of  therapy. Biotechnological advances of spinal decompression indeed reveal promising results for the future of effective management of patients with disc herniation and degenerative disc diseases. The cost for successful nonsurgical therapy is less than a tenth of that for surgery.