Cervical Traction
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2021 ◽  
Yuxin Liu ◽  
Shuangqing Zhai ◽  
Xiuchao Liu ◽  
Jintao Liu

Review question / Objective: P: Patients diagnosed with cervical spondylotic radiculopathy (CSR). I: The treatmen group will be treated with traditional Chinese medicine therapies (with/without additional treatment) including acupuncture of several types (acupuncture, acupoint sticking, acupoint injection, electroacupuncture and so on), massage, cervical traction, fire needle, traditional Chinese medicine hot compress, or their combination. No restrictions are imposed on length of the treatment period, times of treatment, and frequency of treatment. C: The traditional Chinese medicine therapies (with/without additional treatment) including acupuncture of several types (acupuncture, acupoint sticking, acupoint injection, electroacupuncture and so on), massage, cervical traction, fire needle, traditional Chinese medicine hot compress, or their combination will be included in this review. S: Only randomized controlled trials (RCTs) will be included.

John Ong Ying Wei ◽  
Tin Chan ◽  
William Lo ◽  
Buddhika Wimalachandra

Atlantoaxial rotary subluxation (AARS) is a rare condition that may cause persistent torticollis if not treated appropriately. AARS is associated with ligamentous abnormalities, which may result from acquired or congenital disorders. We report the case of a paediatric patient with congenital Marfan syndrome and AARS due to a minor traumatic head injury. A 9-year-old boy with a known diagnosis of Marfan syndrome (and extensive family history) encountered a traumatic head injury that presented as torticollis with a typical “cock-robin” head and neck orientation. AARS was diagnosed through a head and neck CT scan. He underwent initial conservative treatment involving a muscle relaxant (diazepam) and Miami-J collar. This was followed up with manipulation under anaesthesia (MUA) and further cervical traction, which resolved the subluxation without more invasive treatment. To the best of our knowledge, AARS associated with Marfan syndrome has been rarely reported in literature. It is postulated that the ligamentous laxity associated with Marfan syndrome would increase the patient’s predisposition to AARS and more importantly, the propensity to require more invasive treatment (internal fixation). However, our patient unexpectedly responded well to conservative management, namely MUA and cervical traction. This illustrates that despite the increased ligamentous laxity in Marfan syndrome, it is still advisable to conservatively manage AARS before deciding to perform invasive internal fixation.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S15

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255998
Thomas Rulleau ◽  
Sophie Abeille ◽  
Lydie Pastor ◽  
Lucie Planche ◽  
Pascale Allary ◽  

Background Cervical radiculopathy is a relatively common and disabling condition involving local pain in the neck region and pain that radiates into the upper limb. Recent data suggest that cervical traction may effectively reduce disability and pain, with a dose-response relationship. The main aim of this study was therefore to evaluate the mid-term effect of an intensive cervical traction protocol for patients with cervical radiculopathy on disability, and to compare the effects with those reported by non-intensive protocols in the literature. Methods We conducted a prospective open observational study of 36 patients referred by their general practitioner for symptoms suggestive of cervical radiculopathy. All patients underwent the same treatment: a 30-minute cervical traction protocol, twice a day, for five consecutive days. The main objective was the evaluation of disability at 3 months. We evaluated at baseline (D1), the end of the protocol (D5) and at mid-term (M3) disability, cervical pain, radiating pain, pain on motor imagery, presence of neuropathic pain and medication consumption. The primary outcome was the proportion of patients for whom the Neck Disability Index improved by more than the minimum clinically important difference of 7 points by M3. Results Thirty-six patients were included in this study. The Neck Disability Index improved by more than the minimum clinically important difference in 48.3% at M3. Mean Neck Disability Index (p < .001), mean cervical VAS (p < .001), mean radiating VAS (p < .001), and mean VAS for imagined lateral flexion and rotation (p < .002) improved significantly from D1 to D5 and from D1 to M3. Consumption of medication reduced at each time point. The proportion of patients with neuropathic pain reduced from 61.1% at D1 to 33.3% at D5 and 48.3% at M3. Conclusion Disability reduced by more than the minimum clinically important difference in almost half of the participants following the intensive traction protocol. These results are encouraging and suggest that this complex condition can be treated with relatively simple methods.

Al-Jazzazi, Saleem. Abdulmageed, Et. al.

Cervical radiculopathy Syndrome (CRS) is a common neuro-musculo-skeletal disorder causing pain and disability. Manual therapy interventions including cervical traction with other treatment modalities have been advocated to decrease pain and disability caused by cervical radiculopathy (CR). Al-Qudah & AL-Jazzazi (2021) conducted a new method of Spinal Decompression Therapy (SDT) in patients with Chronic Lumbar Disc Herniation (CLDH) which includes Combination of Lumbar Traction With Cervical Traction (CLTCT) as one intervention. Despite of that this new method clinically reduces pain and disability more effectively than the conventional types of Traction, CLTCT method was not previously used in CR patients nor with Cervical Disc Herniation (CDH). The clinical effectiveness of this new method with other treatment modalities in patients with CRS was not approved yet.  OBJECTIVE: The purpose of the presented work is to identify the effectiveness of rehabilitative program on patients with Cervical Radiculopathy, by (15) sessions for (4) Weeks. The suggested Rehabilitative program consisted of: 1.Supine Soft Full Back, Shoulders and Neck Cupping Massage (CM) for (10) minutes, 2.CLTCT: Combined Lumbar Traction with Cervical Traction as one intervention for (20) minutes, 3.Gradual Therapeutic Exercise Package of Neck Stretching and Strengthening Exercise for approximately (15) minutes. METHODS: In this study, Five outdoor male patients had accepted to participate  and were randomly chosen from Al-Karak Governmental Hospital, All subjects applied the proposed rehabilitative program. The results were analyzed using the SPSS system. RESULTS: indicates that there was statistically significant difference between the pre and post measurements in favor of the post measurements in terms of Pain, Disability. CONCLUSIONS: The present study demonstrated that the use of proposed rehabilitative program has a positive effect on patients with Cervical Radiculopathy.

Al-Qudah, Et. al.

Traction Is Part Of The Evidence Based Manual Physical Therapy Management Due To Its Mechanical Nature. The Efficacy Of Lumbar Traction (Lt) Has Been Established, Lt As The Most Used Method Of Spinal Decompression Therapy (Sdt) Reduces The Intradiscal Pressure And Vertically Increases The Intervertebral Space And Restore Disc Height Allowing Nutrients And Oxygen Supply To The Disc. While Lt Had Recently Been Used As A Conservative Treatment For Chronic Lumbar Disc Herniation (Cldh), Combined Lumbar Traction With Cervical Traction (Cltct) As One Intervention Which Has Been Suggested By (Al-Qudah, M.K) Was Used As A Part Of Rehabilitative Program In Patients With Cldh. Therefore, The Effectiveness Of Cltct Separately At Any Other Interventions Remains Absolutely Unclear And Uncertain. Objective: The Aim Of The Presented Work Is To Identify The Effectiveness Of Cltct [(Positional Sustained Lumbar Traction (Pslt) Combined With Mechanical Sustained Cervical Traction (Msct) As One Intervention] On Patients With Moderate (L4-L5) (L5-S1) Cldh, And To Compare Cltct With Traditional Mechanical Lumbar Traction (Mlt). Methods: In This Study, Twelve Outdoor Male Patients Diagnosed With Magnetic Resonance Imaging (Mri), Had Accepted To Participate The Study. They Were Chosen From Al-Karak Governmental Hospital, From 20th Of December To 1st February 2021. Subjects Were Divided Randomly In To Two Groups, Experimental Group (N=6) Performed Cupping Massage (Cm), Cltct And Core Stabilization Exercise (Cse), While The Control Group (N=6) Performed Cm, Mlt And Cse. All Subjects Were Advised To   Perform The Cse Three Times Daily As A Home Program In Addition To One Set During Each Session Under The Therapist Supervision. All Subjects Had Exposed (18) Sessions For (6) Weeks. The Results Were Analyzed Using The Spss System. Results: Indicates That There Was Statistically Significant Difference Between The Pre And Post Measurements In Both Groups In Favor Of The Post Measurements In Term Of Pain And Disability. Also Results Indicate That There Was Statistically Significant Difference Between The Groups In Favor Of Experimental Group. Conclusions: The Present Study Demonstrates That The Use Of Cltct Has A Positive Effect On Patients With Cldh More Than Mlt.  

Nikita G. Alexiades ◽  
Belinda Shao ◽  
Bruno P. Braga ◽  
Christopher M. Bonfield ◽  
Douglas L. Brockmeyer ◽  

OBJECTIVE Cervical traction in pediatric patients is an uncommon but invaluable technique in the management of cervical trauma and deformity. Despite its utility, little empirical evidence exists to guide its implementation, with most practitioners employing custom or modified adult protocols. Expert-based best practices may improve the care of children undergoing cervical traction. In this study, the authors aimed to build consensus and establish best practices for the use of pediatric cervical traction in order to enhance its utilization, safety, and efficacy. METHODS A modified Delphi method was employed to try to identify areas of consensus regarding the utilization and implementation of pediatric cervical spine traction. A literature review of pediatric cervical traction was distributed electronically along with a survey of current practices to a group of 20 board-certified pediatric neurosurgeons and orthopedic surgeons with expertise in the pediatric cervical spine. Sixty statements were then formulated and distributed to the group. The results of the second survey were discussed during an in-person meeting leading to further consensus. Consensus was defined as ≥ 80% agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). RESULTS After the initial round, consensus was achieved with 40 statements regarding the following topics: goals, indications, and contraindications of traction (12), pretraction imaging (6), practical application and initiation of various traction techniques (8), protocols in trauma and deformity patients (8), and management of traction-related complications (6). Following the second round, an additional 9 statements reached consensus related to goals/indications/contraindications of traction (4), related to initiation of traction (4), and related to complication management (1). All participants were willing to incorporate the consensus statements into their practice. CONCLUSIONS In an attempt to improve and standardize the use of cervical traction in pediatric patients, the authors have identified 49 best-practice recommendations, which were generated by reaching consensus among a multidisciplinary group of pediatric spine experts using a modified Delphi technique. Further study is required to determine if implementation of these practices can lead to reduced complications and improved outcomes for children.

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