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Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial

Lookup NU author(s): Dr Barbara Gregson, Professor Alexander Mendelow

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Abstract

Purpose: Backache and sciatica due to protuberant disc disease is a major cause of lost working days and health expenditure. Surgery is a well-established option in the management flowchart. There is no strong evidence proving that traction for sciatica is effective. We report a pilot prospective randomized controlled trial comparing inversion traction and physiotherapy with standard physiotherapy alone in patients awaiting lumbar disc surgery. This study sought to study the feasibility of a randomized controlled trial on the effect of inversion therapy in patients with single level lumbar discogenic disease, who had been listed for surgery. Methods: This was a single centre prospective randomized controlled trial undertaken at the Regional Neurosciences Centre, Newcastle Upon Tyne, UK. It was a prospective randomized controlled trial where patients awaiting surgery for pure lumbar discogenic disease within the ambit of the prestated inclusion/exclusion criteria were allocated to either physiotherapy or physiotherapy and intermittent traction with an inversion device. Posttreatment assessment made by blinded observers at 6 weeks for various outcome measures included the Roland Morris Disability Questionnaire (RMDQ) Score, Short Form 36 (SF 36), Oswestry Disability Index (ODI), Visual Analogue Pain Score (VAS), magnetic resonance imaging (MRI) appearance and the need for surgery. Avoidance of surgery was considered a treatment success. Results: Twenty-six patients were enrolled and 24 were randomized [13 to inversion + physiotherapy and 11 to physiotherapy alone (control)]. Surgery was avoided in 10 patients (76.9%) in the inversion group, whereas it was averted in only two patients (22.2%) in the control group. Cancellation of the proposed operation was a clinical decision based on the same criteria by which the patient was listed for surgery initially. There were no significant differences in the RMDQ, SF 36, ODI, VAS or MRI results between the two groups.Conclusion: Intermittent traction with an inversion deviceresulted in a significant reduction in the need for surgery. Alarger multicentre prospective randomized controlled trial isjustified in patients with sciatica due to single level lumbar discprotrusions.


Publication metadata

Author(s): Prasad KSM, Gregson BA, Hargreaves G, Byrnes T, Winburn P, Mendelow AD

Publication type: Article

Publication status: Published

Journal: Disability and Rehabilitation

Year: 2012

Volume: 34

Issue: 17

Pages: 1473-1480

Print publication date: 01/08/2012

ISSN (print): 0963-8288

ISSN (electronic): 1464-5165

Publisher: Informa Healthcare

URL: http://dx.doi.org/10.3109/09638288.2011.647231

DOI: 10.3109/09638288.2011.647231


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