The Functional and Morphological Changes of the Cervical Intervertebral Disc after Applying Lordotic Curve Controlled Traction: A Double-Blind Randomized Controlled Study

Abstract

The newly developed cervical lordotic curve-controlled traction (C-LCCT) appears to be an ideal method to improve the treatment outcome in patients with cervical intervertebral disc disease. The purpose of this study was to investigate the treatment outcomes of C-LCCT including the functional and morphological changes of the cervical intervertebral disc compared to traditional traction (TT) with a randomized controlled trial design. A total of 40 patients with cervical intervertebral disc disease at the C5/6 level confirmed by magnetic resonance imaging were recruited and assigned to either the C-LCCT group or the TT group. The comprehensive health status changes of the patients were recorded using pain and functional scores (Visual Analogue Scale, Oswestry Disability Index) and morphological changes (cervical lordosis, cervical central canal area) before and after the traction treatment. Both groups showed a significant improvement in pain scores after traction (p < 0.05). The functional score and morphological changes improved significantly after treatment in the C-LCCT group. However, there was no significant improvement in the TT group (p < 0.05). The C-LCCT showed significant pain, functional, and morphological improvement compared to TT. C-LCCT could be effective in improving the treatment outcomes of the traction technique in patients with cervical intervertebral disc disease.

Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials

“…Note that 'other' indicates articles also deemed irrelevant as topics included medication trials, children cohorts, genetic diseases, bone density loss, range of motion studies, dental, trial registry, biomechanical modeling, cancer cohorts, not a clinical trial or trials on irrelevant treatments including massage therapy, acupuncture, Chinese medicine, music therapy, spiritual healing, kinesiotaping, shockwave therapy, cutaneous nerve stimulation, and other holistic therapies. The remaining 126 articles were screened for inclusion criteria, leaving 9 controlled trials, 6 RCTs [48][49][50][51][52][53] and 3 nRCTs 35,54,55) (Table 1).…”

“…The 9 included trials involved a total of 299 CET intervention patients suffering from the primary conditions of chronic neck pain (n=63 54,55) ), cervical disc disease (n=20 48) ), spondylotic radiculopathy (n=15 51) ), discogenic radiculopathy (n=30 52) ), myofascial pain syndrome (n=60 49) ), cervicogenic dizziness (n=36 50) ), fibromyalgia (40 53) ), or simply cervical hypolordosis (n=35 35) ). Trials included a total of 315 controls including patients who received comparative treatments less CET (comparative treatment groups, n=231 35,[48][49][50][51][52][53] ) or patients who served as traditional controls (no treatment, n=84 35,54,55) ). The extracted data from the trials is shown in Table 1.…”

“…Also, when considering the percentage of lordosis increase by treatment number, the trials are comparable at about 0.4-0.45° improvement per treatment. The 1994 trial 35) shows half this (0.22°/treatment) and a 2019 trial 48) on the adapted axial traction table shows 2.4°/treatment. The latter trial was conducted on patients with cervical disc disease, and it is not known if these patients may respond differently than patients suffering from other cervical spine disorders; there are also more critical concerns about this trial that we will discuss.…”

“…It is noted that although all trials demonstrated improvements in lordosis in CET treated patients, treatments were typically limited to 2.5 to 3-months and limited to 30-38 treatments (with two exceptions 35,48) ). The ending curvature improvements in CET treated groups were not considered physiologically ideal as an end of goal result 11,12,56,57) .…”

“…The third nRCT (2003 54) ), utilized an extension-compression with a posterior-to-anterior transverse mid-neck pull while the patient was in a seated position. Many of the RCTs 49,50,52,53) featured the cervical Denneroll traction orthotic (Denneroll Spinal Orthotics, Wheeler Heights, NSW, Australia), and one trial 48) used a modified traditional axial-distraction cervical traction table (Kinetrac KNX-9900 Hanmed Co., Gimhae, Republic of Korea) with a cervical support that placed a posterior-to-anterior push onto the mid neck while the patient lay supine. While it is unknown which traction approach is most effective, as taught through CBP© seminars (www.idealspine.…”