Lumbar Traction

1
Lumbar Traction

• Chapter 17

2
Lumbar Traction

• Comparison Cervical and Lumbar Traction
• Similar
• Separating the vertebrae
• Difference
• Friction, muscle, soft tissue tension, and weight
  of the lower extremity is a strong counterforce
  in lumbar traction, requiring more tension to
  separate the vertebrae
• Force is approximately ½ the body weight
• Split table reduces friction
• Patient position has more influences on angle of
  pull in lumbar traction

3
Indications

• Spinal nerve impingement
• Disk herniations
• Muscle spasm
• Radicular pain

4
Contraindications

• Pain of unknown origin
• Acute injury
• Unstable spinal segments
• Cancer, meningitis, or other spinal cord/
  vertebrae disease
• Vertebral fracture
• Extruded disk fragments

5
Patient Position Supine

• Increases flexion
• Supine and Flexion
• Further increases flexion
• 46-60 L5-S1
• 60-75 L4-L5
• 75-90 L3-L4
• 90 Posterior intervertebral space
• Extension
• Opens facet joints and increases distraction in
  upper lumbar

6
Patient Position Prone

• Used when excessive flexion or lying supine
  causes pain
• Benefits
• Allows other modalities to be used during
  traction
• Effects the lower disk protrusions
• Optimal Position
• Experience
• Trial and error

7
Types of Lumbar Traction

• Inversion
• Gravitational
• Autotraction
• Mechanical

8
Inversion Traction

• Suspended upside down
• Lengthens spine by the weight of the patient
• Hazards
• Hypertension
• Cardiovascular
• Glaucoma

9
Gravitational Traction

• Patient is Upright
• Can increase posterior disk space between L1-S1
• Torso harness may be uncomfortable

10
Autotraction

• Support body weight by hanging from a bar or arm
  chair
• Relaxing spinal muscles can distract vertebrae

11
Mechanical Traction Application

• Motorized lumbar traction
• Determine body weight
• Remove material that may interfere with halter
• Adjust halter accordingly
• Traction halter Pelvis
• Stabilization harness 8th-10th Ribs

12
Mechanical Traction Application

• Unlock split table and align target spinal
  segment over the opening in the table
• Secure and connect halter
• Align angle of pull to correspond with specific
  pathology
• Explain treatment to patient and give safety
  switch

13
Initiation of Treatment

• Set controls to zero and turn on unit
• Adjust ratio
• Tension
• Approximately 25 of body weight
• Radicular pain caused by disk herniation 30 to
  60 of body weight
• Duration
• Corresponding to pathology
• Instruct patient to remain relaxed

14
Termination of Treatment

• Tension
• Gradually reduce over 3 or 4 cycles
• Gain slack and turn unit OFF
• Many units have an auto OFF sequence
• Remove halter from unit and patient
• Patient remains in position for 5 minutes after
  the treatment

15
Manual Traction

• Helps determine the direction and amount of force
  to apply mechanically
• In rare instances manual traction can be
  substituted for mechanical traction
• Can be applied using a belt that allows the
  clinicians body weight to deliver the force