Non-operative correction of flat back syndrome using lumbar extension traction: a CBP® case series of two.
Deed E Harrison, Paul A Oakley
PMID 30154615WHAT IT FOUND
Two men with chronic low back pain and flexible flat back reported pain as 1/10 after 100 and 70 treatments.
Lumbar manipulation and extension traction were given together, so neither can be credited alone.
Key findings
01Both patients received lumbar spinal manipulative therapy for the first 2-3 weeks, 4-5 times per week, and lumbar extension traction, so the contribution of each treatment cannot be separated.
02At 38.5 weeks after treatment ended, Case 1 reported pain as 1/10 and lumbar lordosis -36 degrees versus +14 degrees, with radiographic parameters stable or further improved without treatment.
03Case 2 reported pain as 1/10 versus 8.5/10 and lumbar lordosis -28 degrees versus -12 degrees after 35 treatments over an additional 8 weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only two patients were reported, so this cannot show what most patients would do. There was no control group or random assignment, so improvement over time cannot be compared with usual care or no treatment. Both patients received lumbar spinal manipulation and lumbar extension traction, so the separate effect of traction cannot be identified. Only Case 1 had long-term follow-up; the long-term result for Case 2 is unknown. The patients were young and may not represent typical surgical candidates for flat back syndrome. The paper compares cost to surgery, but it does not report cost outcomes for the patients or a formal economic analysis.
Declared interests
One author was paid by CBP NonProfit for writing the manuscript. Another author teaches 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 lumbar extension traction works. It reports two patients, and both also received lumbar spinal manipulation, so the study cannot separate the effects of traction from manipulation or from time.