Efficacy of Gravity Lumbar Reduction Therapy in Symptomatic Prolapsed Intervertebral Disc Patients: A Radiological Evaluation Based on Inter-Vertebral Dimensions

ABSTRACT

Background: Gravity lumbar reduction therapy is one of the traction modality that uses gravitational force created by the lower part of the body while suspending the patient in erect position for treating patients with symptomatic prolapsed intervertebral disc. The efficacy of various forms of traction in treating such cases has not been quantitatively analyzed; rather their efficacy is based on empirical information. Objective: The current study was done to observe the changes in intervertebral dimensions after gravity lumbar reduction therapy in patients with prolapsed inter-vertebral disc. Methods: An interventional clinical trial was done in the Department of Physical Medicine & Rehabilitation, JNIMS, Imphal during the period Oct 2017-June 2018. Thirty (30) consecutive, MRI confirmed symptomatic prolapsed inter-vertebral disc cases who could achieve 900 of inclination on gravity lumbar reduction device were the study-subjects. Measurements of intervertebral dimensions were compared in digital x-ray lateral views taken before and after 30 minutes of suspension on specially designed gravity lumbar reduction device. Results: Gravity lumbar reduction therapy produces significant changes in mean inter-vertebral heights at L2-L3, L3-L4, L4-L5, L5-S1 levels with mean (SD) changes in anterior, middle, posterior and foramina heights (in mm) of 0.92 (2.14), 1.87 (1.82), 2.28 (1.44), 3.65 (2.19) respectively with improvement in disability, pain and other clinical parameters. Most prominent separation was seen in posterior margin L4-L5, and least separation at anterior margin at L4-L5. Conclusion: Gravity Lumbar Reduction Therapy could be an effective, low cost easy method of lumbar traction in symptomatic lumbar inter-vertebral disc prolapsed cases.