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What is Decompression Therapy?
Intervertebral Disc Decompression is a modern non-surgical technology providing decompression therapy to the spine. It comprises of a series of treatment sessions that are specifically designed for each patient.
- 1. Computerized & personalized program based on the patient’s pathology.
- 2. Mobilize and manipulate specific spinal segments to induce negative intradiscal pressure.
- 3. Designed to provide static, intermittent and cyclic oscillation forces.
- 4. Forces applied to a specific disc in variable direction, frequency and amplitude.
How does it work?
This technology is designed to provide non-surgical treatment utilizing differential dynamics. This relieves pressure on the spinal nerves involved, especially those associated with herniated discs, degenerative disc disease, posterior facet syndrome, and alleviates sciatica. The treatment protocol achieves these effects through decompression of intervertebral discs, unloading through distraction and positioning. Each treatment session is designed according to the level of problem. During the session, the patient is closely monitored and after 10 treatments, the patient is reviewed for progress which can be in terms of pain, motor activity, sensation, function & ROM.
THE TECHNOLOGY BEHIND IT
Patient specific information is entered into the computer and the computer analyzes the data and creates a specific protocol.
- Progression Time
- Decompression Weight
- Regression Time
- High Hold
- High Tension
- Low Hold
- Oscillation Parameters
- Transition Time
- Target Level L4, L5, S1
The IDD system can isolate each vertebra (L1, L2, L3, L4, L5 etc.) depends on the angulation in the set up.
25 session, 20 sessions over 10 weeks and 5 maintenance session over 5 months. This will insure long term success. Patient starts to feel better after the 5th-7thsession.
IDD is a highly integrated software program allowed to keep real time tracking of the force applied to the specific segment of the spine that is injured.
The IDD program gives real time patient response, to the specific program applied during therapy session to ensure suitability of the forces applied.
DIFFERENT OSCILLATION WAVEFORMS
The first graph illustrates the patient is lagging on the IDD Graph. The graphs below then detail specifically how we can cater to each patient depending on their specific need. Whether they need low, medium, or high level oscillation. We also have low and high amplitude.
The 3DD Technology
LUMBAR SPINE ANATOMY
- Lumbar Refers to lower back.
- Built for both power and flexibility.
- Consist of five vertebrae (L1-L5) which enables the spine to support the weight of the entire torso.
- The lowest two spinal segments (L4-L5 and L5-S1) bears the most weight and prone to degradation and injury.
- The lumbosacral joint (L5-S1) allows for considerable rotation, allowing the hip and pelvis to swing when walking and running.
LUMBAR DISC ANATOMY
- 1. The disc approximately 8 - 10mm in height and 4 cm in diameters.
- 2. It’s 25% of the total height of the vertebral column
- 3. Consisted on nucleus pulposus and annulus fibrosus.
LUMBAR SPINE ANATOMY & PAIN
Lumbar Spine Segment
- Healthy disc has a sponge like substance and is cushiony.
- Acts similar to shock absorber in the spine
- The lumbar spine segment (adjacent vertebrae) are connected by facet joints.
- This allows movement to bend and twist the low back in all directions.
- There are nerves that branch off from the spinal column at each level. They pass through small holes and connect together to form the sciatic nerve.
- The sciatic nerve travels into the legs down the back of each thigh and into the calves and feet.
LUMBAR SPINE ANATOMY & VASCULAR SUPPLY
- 1. The nucleus and annulus has no direct blood supply. Nutrients reach them via osmosis.
- 2. Spinal artery give branches to the longitudinal ligaments to either side of the disc and occasionally in the outermost portion of the annulus.
- 3. Branches from the segmental artery provides blood supply to the vertebral body and the end plate of the disc.
LUMBAR SPINE ANATOMY & NUTRITION EXCHANGES
- 1. The disc depends solely upon bulk fluid flow for the transport of large molecule and diffusion for the transport of small molecules.
- 2. Molecules travels about 20 mm from the blood source to the center of the disc.
- 3. Molecules transported must exit from the capillaries into the subchondral bone, cross the vertebral end plate and travel through the extracellular matrix of the disc to the core of the disc.
- 4. This journey must be traveled in reverse for the removal of metabolic waste.
- 5. Studies showed using gadolinium enhanced MRI that molecules took 2 hours to cross the endplate from the vertebral body and 4 hours to accumulated to a significant degree in the center of the disc.
- 6. Electrochemical events as well as mechanical barriers dictate the velocity of the disc tissue -fluid exchange.
In healthy adult T2 weighted MRI, signal intensity (high concentration of water) is elevated in the morning after 8 hours laying down and lower in the evening after several hours of standing or sitting.
Loading and unloading the spine appears to create gradients that influence the degree of tissue fluid exchange.
Any degree of inability to perform fluid exchange is a key element of degenerative disc disease.
MODULATED IMMUNE RESPONSE
When NP extruded from the AF to the host circulation it produce number of inflammation mediators :
- Phospholipase A2
- Prostaglandi E2
- Interleukin a,b
- Tumor Necrosis Factor (TNF)
- Nitric Oxide
- Nerve Growth Factor
This produces an intense inflammatory process.
Results of this Battle
- First Stage - Eliminate dead cells and tissue debris that lead to absorption of the disc material.
- Later Stage - Secretion of anti- inflammatory cytokines ad growth factors.
- End Result - Restoration of immune homeostasis.
The treatment goal is to help the body win the battle by restoring the gradient pressure to improve hydration and nutrient delivery to the nucleus.