Increasing the cervical and lumbar lordosis is possible despite overt osteoarthritis and spinal stenosis using extension traction to relieve low back and leg pain in a 66-year-old surgical candidate: a CBP® case report.
Michael T Weiner, Paul A Oakley, Alyssa K Dennis and 2 others
PMID 30464366WHAT IT FOUND
In a single surgical candidate with low back and leg pain, extension traction, manipulation and exercises coincided with less disability and increased cervical and lumbar lordosis.
The combined treatment means no single part can be credited.
Key findings
01At follow-up, the Oswestry disability score was 18% and the lower extremity functional scale score was 85%, compared with 62% and 32% at presentation.
02Follow-up assessments reported orthopedic tests and cervical and lumbar ranges of motion within normal limits after 39 sessions, and increased spinal range of motion with unremarkable orthopedic tests after 78 sessions overall.
03Repeat radiography reported a 7.6° increase in lumbar lordosis measured from L1-L5, an 11.4° increase measured from L1-S1, and a 10.5° improvement in cervical lordosis.
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
The report describes one patient, so it cannot show what would happen in other patients. There was no long-term follow-up. The spinal alignment was still suboptimal at the last assessment. The patient received extension traction, spinal manipulative therapy, and extension exercises together, so the contribution of any single component cannot be separated. The patient had refused recommended lumbar surgery and sought alternative treatment, so it may not represent patients who accept surgery.
Declared interests
PAO is paid by CBP NonProfit for writing the manuscript; DEH teaches chiropractic rehabilitation methods and sells products to physicians for patient care used in this manuscript.
The easy way to misread this
Do not read this as evidence that extension traction alone can avoid surgery or relieve stenosis. It is one person, not a pattern, and the patient received traction, spinal manipulation and exercises together.