post operative lumber disc prolapse!!!

junior_physiotherapist · 08-05-2007 09:09 PM

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Actually these figures of traction in the cervical region are used for mechanical separation of the vertebrae as used in reducing the dislocations of subluxations of vertebrae in the spinal region.[/QUOTE]

Hallo,

My question is how i'll apply a traction force for this patient and is just post operative of lumber disc prolabse since 6 months ,,so what about tension which 'll develope in trapeziues mucsles as a result of tracion force

Regards

**sdkashif** · 08-06-2007 03:13 AM

Here are few findings from literature.

These findings are for cervical traction procedures.

Most experiments with poundage above 20lb (9KG), some of very high, separated vertebrae by about 1-1.5mm per space, measured at posterior cervical level.

By far the greatest separation occurs posteriorly and is greatest with increasing flexion.

The normal cervical lordosis is eradicated at pulls of about 20-25 lb (9-11 KG).

A traction force of 30 lb (13.5 KG) for only 7 seconds will separate vertebrae posteriorly, the amount increasing with flexion.

At a constant angle, a traction force of 50 lb (22.5 KG) produces greater separation than 30 lb (13.5 KG) but the amount of separation is not significantly different at 7, 30, 60 seconds.

When separation of vertebral bodies is desired high traction forces with short periods will achieve it.

Upper cervical segments do not separate so easily as lower cervical segments.

Rhythmic traction traction produces twice as much separation as sustained traction.

When traction forces are removed, restoration to normal dimensions is four to five times quicker in posterior structures. Restoration in anterior structures is much slower.

As would be expected less separation occurs in 50 years old patients than in normal 20 years.

Generally for vertebral separation,

In cervical spine, under friction free circumstances, a force of approximately 7 percent of the total body weight separates the vertebrae. A minimum force of 11.25 to 13.5 KG (25 to 30 lb) is necessary to lift the weight of head when sitting and to counteract the resistance of muscular tension. The greatest amount of separation occurs during the first few minutes if treatment at a given forces. For achieving muscle relaxation a traction force is required at level less than those needed for mechnical separation ( 4.5 to 6.75 KG, or 10 to 15 lb) in cervical spine.

In lumbar spine, a minimun friction free force of half the body weight is necessary for mechnical separation. To avoid treatment soreness, the first treatment should not exceed half the patient's weight.

The dosage chosen for the initial treatment should be less than that which cause vertebral separation. Progression of pundage should be determined by patient response and problem being treated.

The duration will depend on the type of traction ( intermittent or sustained), the poundage used, the clinical condition of patient and the goals of treatment.

Traction used for reduction dislocation and subluxation in cervical region are generally higher, up to 140 lb, is used in skeletal traction for reducing the verterae. These figures are very high as compared to spinal traction used for therapeutic pain relieving purpose.

Clinical trials of patients who have under gone one or more surgical procedures 45 % had good pain relief as compared to non surgical group which were 87 %. ( Mobilisation of Spine by G.P.Grieve).

The references for the above mentioned detail are:

Therapeutic Exercises, Foundation and Techniques, 3rd edition, By Kisner and Colby

INITIAL CLOSED REDUCTION OF CERVICAL SPINAL FRACTURE-DISLOCATION INJURIES

Mobilisation of Spine, Fifth Edition by G.P.Grieve.

For additional details please have a look over the attachments with this post.