NON SURGICAL SPINAL DECOMPRESSION Dr. Douglas A. VanderPloeg
CONTENTS I. Incidence of L.B.P. II. Anatomy Review III. IV. Disc Degeneration, Bulge, and Herniation Non-Surgical Spinal Decompression 1. History 2. Procedure 3. Scientific Research 4. Clinical Outcomes V. Our Clinical Experience
INCIDENCE OF LBP Page 4 80% 80-90% 25-60% 33% Will experience low back pain at some time in their life Will experience relief in 6 weeks Will experience a 2 nd episode at 1 year or longer after initial episode. Will develop chronic L.B.P. with 1 in 5 reporting substantial limitation to their activities. Source: Anesthesiology News Pain Medicine Special Report
INCIDENCE OF LBP Page 5 L.B.P. is 2 nd most common reason for visit to physician. 3 rd most common indication for surgery. 5 th most common cause of hospital admission. Source: Anesthesiology News Pain Medicine Special Report
INCIDENCE OF LBP Causes of Low Back Pain Page 6 Herniated Disc Disc Bulge Degenerative Disc Disease Tumor Infection Fracture
ANATOMY REVIEW Disc Degeneration, Bulge, and Herniation Page 7
ANATOMY REVIEW Disc Degeneration, Bulge, and Herniation Page 8
ANATOMY REVIEW Disc Degeneration, Bulge, and Herniation Page 9
HISTORY Non Surgical Spinal Decompression Page 10 Allan Dyer, M.D. Ph.D. is the inventor and founder of the revolutionary technology behind Spinal Decompression. As former Deputy Minister in Health in Ontario, Canada Dr. Dyer made many contributions to health. Among other things, Dr. Dyer s research led to the development of the heart defibrillator.
PROCEDURE Non Surgical Spinal Decompression Page 11 Dr. Dyer discovered that by slowly increasing the pull-tension on the spine, followed by a hold and then partial release a vacuum could be created within injured discs. This vacuum was found to assist in repositioning extended disc material back into place. In 1991 after more than six years of research and development with a team of physicians, engineers, and technicians at a major hospital, Dr. Dyer introduced the first generation Spinal Decompression unit.
SCIENTIFIC RESEARCH Non Surgical Spinal Decompression Page 12 Effects of Vertebral Axial Decompression on Intradiscal Pressure Intradiscal pressure measurements showed that distraction tension routinely applied by the VAX- D equipment reduced the intradiscal pressure significantly to negative levels in the range of -100 to -160 mm Hg. When the threshold was exceeded the intradiscal pressure was observed to decrease dramatically to levels in excess of 300mm Hg, below the positive pressure prior to the application of pelvic tension. Effects of Vertebral Axial Decompression on Sensory Nerve Dysfunction in Patient with Low Back Pain and Radiculopathy The results after therapy were as follows: 14/22 nerves (64%) returned to normal function, 6/22 (27%) improved. 1/22 (4.5%) showed deterioration. The average neurometer grade before therapy was 6.36 and after therapy 2.09 (a score of zero indicates normal function.) Overall improvement was 67% (p<0.05). Gustavo Ramos, M.D.; and William Martin M.D. J Neurosurgery 81: 350-353 1994 Frank Tilaro, M.D.; Dennis Miskovich, M.D.: Canadian Journal of Clinical Medicine Vol.6, No.1; Jan. 1999
SCIENTIFIC RESEARCH Non Surgical Spinal Decompression MRI Evidence of Nonsurgical, Mechanical Reduction Page 13 Some rehydration occurs. Transligamentous ruptures show lesser repair. MRI imaging of 20 patients treated with decompression table shows in our study over 90% reduction of subligamentous nucleus herniation in 10 of 14. Torn annulus repair is seen in all. Facet arthrosis can be shown to improve chiefly by pain relief. Virtually all subjects have sufficient relief of pain to return to work.
CLINICAL OUTCOMES Non Surgical Spinal Decompression Page 14 Irrespective of MRI status, all but three patients had significant pain relief and complete relief of weakness when present and of immobility. Numbness in the leg disappeared in all but one patient who had far lateral disc herniation and in two with foraminal stenosis without much herniation. Disc herniation, 10 out of 14 had 90% improvement in pain and disability, two had roughly 50% relief, and one had only 20% relief. Foraminal syndrome but without much frank herniation of disc, four had 75-100% improvement in pain, one had 50% relief, and one with severe spinal stenosis had little relief and was sent for surgery. Thus, the degree of improvement roughly followed the MRI changes. Edward L. Eyerman, M.D.; Journal of Neuroimaging Vol. 8, No.2; April 1998
CLINICAL OUTCOMES Non Surgical Spinal Decompression Page 15 VERTEBRAL AXIAL DECOMPRESSION THERAPY FOR PAIN ASSOCIATED WITH HERNIATED OR DEGENERATED DISCS OR FACET SYNDROME: AN OUTCOME STUDY
CLINICAL OUTCOMES Non Surgical Spinal Decompression Page 16 Only patients who had a diagnosis of herniated disc, degenerative disc, or facet syndrome, which were confirmed by diagnostic imaging, were included in this study; a total of 778 cases. The average time between the initial onset of symptoms and the beginning of this therapy was 40 months, and it was four months or more in 83% of the cases. The treatment was successful in 71% of the 778 cases, when success was defined as a reduction in pain to 0 or 1, on a 0 to 5 scale. Improvements in mobility and activities of daily living correlated strongly with pain reduction. The causes of back pain and their relationship to this therapy are also discussed. Earl E. Gose, et al; Journal of Neurological Research Vol.20, No.23; April 1998
CLINICAL OUTCOMES Non Surgical Spinal Decompression - Thomas A. Gionis and Eric Groteke Page 17 Our results indicate that in treating 219 patients with MRI-documented disc herniation and degenerative disc disease, treatment was successful as defined by: pain reduction reduction in use of pain medications normalization of range of motion reflex, and gait recovery of sensory or motor loss. Nonsurgical spinal decompression provides a method for physicians to properly apply and direct the decompressive force necessary to effectively treat discogenic disease. Symptoms were restored by suggestive report in 86% of patients previously thought to be surgical candidates and mechanical function was restored in 92% using objective data. Thomas A. Gionis is chairman of the American Board of Healthcare Law and Medicine, Chicago; a diplomatic professor of surgery, American Academy of Neurological and Orthopedic Orthopedic Technology Review Vol.5, No.6 November/December; pages: Cover, 36-39
CLINICAL OUTCOMES Non Surgical Spinal Decompression Wooridul Neurosurgery Clinic, 2005 Page 18 The DRX 9000 84 patients underwent non-surgical decompression therapy with the DRX 9000 in the author s Hospital. 34 patients- intervertebral disc disruption 39 patients- herniated lumbar disc. 11 patients- degenerative disc disease. Overall success rate was 87% Program of the 45 th Annual Meeting of the Korean Neurosurgical Society; October 12-15, 2005
OUR CLINICAL EXPERIENCE Non Surgical Spinal Decompression Page 4 0% 100% 80% No known adverse risks. 2 Two patients did not tolerate procedure. All patients have failed prior treatment including one or more of the following: Physical Therapy Medications Spinal Pain Injections Surgery Chiropractic Acupuncture Success Rate of 80% plus One patient returned for additional treatment. One year follow-up yielded 90% plus nonrecurrent pain
CONTACT US Maine Spine and Nerve Institute The vast majority of patients treated at Maine Spine & Nerve Institute have received care for their peripheral neuropathy, neuromusculoskeletal pain, or spinal pain before entering this office. 200 Professional Dr., Suite 2 Scarborough, ME 04074 Office: 207-613-7974 Fax: 207-219-8082 Facebook.com/MaineSpineNerve Google.com/+MaineSpineNerveInstituteScarborough Dr. Douglas A. VanderPloeg
Page 4