Saturday, 5 December 2015

Assessment of dynamic traction therapy in lumbar disc herniation by clinical and magnetic resonance imaging outcomes

Abstract

Introduction: “Dynamic traction therapy” (DTT) is a new standardized conservative treatment option in lumbar disc herniation. This study aimed to evaluate the therapeutic effect of DTT in lumbar disc herniation, by correlating both clinical and magnetic resonance imaging (MRI) outcomes.

Materials and methods: In a total of 27 patients (mean age 50.5±9.1), who underwent standardized DTT, MRI was performed before and after therapy and evaluated by two independent radiologists individually and blindly; both grading intervertebral discs according to Pfirrmann classification in terms of degeneration, morphology, localization and nerve root affectation. The effect of standardized DTT on painful herniated discs was correlated with numerical pain rating (NPR) scale from 0 to 10 and clinical outcome.

Results: Significant MRI changes were found in images after therapy compared to before therapy regarding morphology and nerve root affectation (p< 0.05), but disc degeneration grading showed only a tendency towards improvement (p> 0.05), interestingly showing a better disc hydration after therapy. Patients’ NPR decreased from a mean value of 10 to 1 after completed therapy, thus showing a significant change in pain (p< 0.001). Clinical outcome measurements improved significantly after therapy (P<0.001), however changes of MRI grading did not significantly correlate with pain rating and clinical outcome (p>0.05).

Conclusion: Lumbar disc herniation grading showed a positive correlation with patients’ decreased NPR after undergoing standardized DTT, therefore our preliminary results might impact in the therapeutic management of patients complaining of lumbar disc pathology, however further longitudinal studies are recommended.

Keywords Intervertebral disc herniation, traction therapy, Magnetic resonance imaging.

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