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Musculoskelet Sci Pract. 2017 Oct;31:1-8. doi: 10.1016/j.msksp.2017.06.004. Epub 2017 Jun 9.

Age-related differences in the response of the L5-S1 intervertebral disc to spinal traction.

Author information

1
Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT, 84602, USA. Electronic address: rike_mitchell@byu.edu.
2
Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, 1300 Wheat St., University of South Carolina, Columbia, SC, 29208, USA.
3
Department of Exercise Sciences, Brigham Young University, 106 Smith Fieldhouse, Provo, UT, 84602, USA.
4
Department of Electrical & Computer Engineering, Brigham Young University, 459 Clyde Building, Provo, UT, 84602, USA.

Abstract

BACKGROUND:

Lumbar traction is a common treatment for low back pain; however its mechanisms of action are poorly understood. It has been hypothesized that a key effect of lumbar traction is its capacity to influence fluid movement within the intervertebral disc (IVD).

OBJECTIVES:

To determine differences in the apparent diffusion coefficient (ADC) obtained with lumbar diffusion-weighted imaging (DWI) of the L5-S1 IVD before, and during, the application of lumbar traction.

DESIGN:

Case series, repeated measures.

METHODS:

A static traction load of ∼50% of body-weight was applied to the low back using a novel "MRI-safe" apparatus. DWI of the lumbar spine was performed prior to, and during the application of the traction load.

RESULTS:

Participants were currently asymptomatic and included a young adult group (n = 18) and a middle-aged group (n = 15). The young adult group had a non-significant 2.2% increase in ADC (mean change = 0.03 × 10-3 mm2/s, SD = 0.24, 95% CI = -0.09, 0.15). The ADC for the middle-aged group significantly increased by 20% (mean change of 0.18 × 10-3 mm2/s, SD = 0.19; 95% CI = 0.07, 0.28; p = 0.003; effect size = 0.95). There was an inverse relationship between the ADC obtained before traction and the percent increase in ADC that was measured during traction.

CONCLUSION:

Static traction was associated with an increase in diffusion of water within the L5-S1 IVDs of middle-age individuals, but not in young adults, suggesting age-related differences in the diffusion response. Further study is needed to assess the relationship between these findings and the symptoms of back pain.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Back pain; Disc degeneration; Disc health; Fluid flow; Regenerative medicine

PMID:
28624722
DOI:
10.1016/j.msksp.2017.06.004
[Indexed for MEDLINE]

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