Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.

Christian C Apfel,William Martin,Elizabeth George,Maximilian Schaefer,Ozlem S Cakmakkaya,Alex Macario,Charlotte Richmond,Joseph V Pergolizzi

doi:10.1186/1471-2474-11-155

Abstract

BackgroundBecause previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP) due to disc degeneration (discogenic low back pain) and disc herniation, it has accordingly been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration. The goal of this study was to determine if changes in LBP, as measured on a verbal rating scale, before and after a 6-week treatment period with non-surgical spinal decompression, correlate with changes in lumbar disc height, as measured on computed tomography (CT) scans.MethodsA retrospective cohort study of adults with chronic LBP attributed to disc herniation and/or discogenic LBP who underwent a 6-week treatment protocol of motorized non-surgical spinal decompression via the DRX9000 with CT scans before and after treatment. The main outcomes were changes in pain as measured on a verbal rating scale from 0 to 10 during a flexion-extension range of motion evaluation and changes in disc height as measured on CT scans. Paired t-test or linear regression was used as appropriate with p < 0.05 considered to be statistically significant.ResultsWe identified 30 patients with lumbar disc herniation with an average age of 65 years, body mass index of 29 kg/m2, 21 females and 9 males, and an average duration of LBP of 12.5 weeks. During treatment, low back pain decreased from 6.2 (SD 2.2) to 1.6 (2.3, p < 0.001) and disc height increased from 7.5 (1.7) mm to 8.8 (1.7) mm (p < 0.001). Increase in disc height and reduction in pain were significantly correlated (r = 0.36, p = 0.044).ConclusionsNon-surgical spinal decompression was associated with a reduction in pain and an increase in disc height. The correlation of these variables suggests that pain reduction may be mediated, at least in part, through a restoration of disc height. A randomized controlled trial is needed to confirm these promising results.Clinical trial registration numberNCT00828880

Highlights

Because previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP) due to disc degeneration and disc herniation, it has been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration
The two most common diseases involving chronic LBP are discogenic low back pain, responsible for 39% of cases, and disc herniation, accounting for just less than 30% of LBP incidence. These incidence frequencies are supported by the current data that most closely link the clinical pathology of discogenic low back pain and disc herniation to the anatomical structure of the intervertebral disc
A subsequent chart review of 94 patients suggests that motorized non-surgical spinal decompression may be effective in reducing chronic low back pain[10]

Summary

Introduction

Because previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP) due to disc degeneration (discogenic low back pain) and disc herniation, it has been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration. The two most common diseases involving chronic LBP are discogenic low back pain, responsible for 39% of cases, and disc herniation, accounting for just less than 30% of LBP incidence These incidence frequencies are supported by the current data that most closely link the clinical pathology of discogenic low back pain and disc herniation to the anatomical structure of the intervertebral disc. Another treatment option is motorized decompression, a technique designed to lessen pressure on the discs, vertically expand the intervertebral space, and restore disc height[5,6,7]. Preliminary data from a prospective cohort study in patients with chronic low back pain reported a median pain score reduction from 7 to 0 (on a 11-point verbal rating scale) following a 6-week non-surgical spinal decompression treatment protocol[11]

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