In a time where so much attention is given to health care as a right and who is going to pay for healthcare, it is interesting to look at some of the advancements and stagnation of some of the healthcare technologies of the past 20 years. One, in particular, has my attention. Non-surgical spinal decompression. This therapy burst on to the scene back around 1997. It was the new and amazing nonsurgical therapy that was created to treat disc bulge, disc herniation, disc degeneration, and spinal stenosis. Traction had been around since the 1940s in the form of static traction. The kind of traction that you put a weight on a cord and hang a pulley of the end of a surface and try to distract one part from another. It had advanced a bit by the 1970s when motorized interval traction came along and allowed a motor to increase and decrease force in timed intervals which allowed for a pumping mechanism to be achieved. Then in the 1980’s inversion traction, or hanging the patient upside down and letting gravity came about. It worked as the standard for a while until the next big leap in technology occurred which was computerized decompression traction.

Advancements in Technology

The advancement was quite a jump due to the ability of a computer to more accurately monitor and deliver a precise force to the traction pulleys. With tables that could now assist the comfort and movement of the patient and the ability of a doctor to change the timing, force and alternation of pulley forces, the ability of the doctor grew immensely. Now we could slowly alter and observe what would happen with the patient when we changed the small settings on the device. If we allowed for a slower progression of a traction force would it change the outcome? If we changed the angle of the pulley would we be able to more accurately focus the traction? If we raised or lowered the force based on patient size or type of injury, could we get a better result? The answers to these questions seemed to be coming at an incredible rate, and they were amazingly helpful for patients.

Much of this movement seems to be linked to a neurosurgeon named Arlan Dyer MD. He and his team owned a Neurosurgery practice. He was curious if there was a way that traction could be administered that would cut down on the need for low back surgery for patients. The previous treatment methods to computerized traction seemed to be just ok but not great. He set out to do something that only a surgeon with access to patients imminently going into surgery could do, he asked them if he could examine their discs before he performed their fusions as part of a study. He was able to develop techniques to measure the effects of traction weights, styles and timing on discs that were injured. From that information, he was able to estimate logarithmic mathematical approaches for a computer to use to pull on the harnesses to deliver just enough force to a patient without over pulling on their injured discs and without being to nonaggressive that no improvement was had. This led to the development of some of the first large tables out there designed to focus on this task. Companies like VAX-D, Lordex, North American Medical and DRS 9000, spared no expense to deliver tables that could deliver amazingly precise results. There are many other table companies that popped up around the early 2000s to compete and continue to drive forward the progression of making better and better tables to get better results. Some had robotic features, some had reportedly better harness abilities. But the technology race also caused the prices of this equipment to rise higher and higher. It was very common to see this equipment cost a doctor over $100,000 just to get the basic equipment to start the process of being able to treat patients.

Is Cheaper Always Better?

When 2008 rolled around and the financial markets began to fail. It devastated the companies that were pouring money into the advancements of this technology. Virtually overnight the ability for doctors to finance this technology in their practices vanished. Cue the knockoffs. Cheaper tables began to be produced. The computers and motors and functions of the tables that the companies used were dramatically cheaper. But the wave of the previous ten years was still producing a big impact on patients and doctors looking to make a difference. They were not quite as good. But did they need to be at 1/6th the price? The doctors that answer “no” to that question are likely more focused on the business end of their practice. The Doctors that answer “Yes”, are likely really looking at outcomes. Myself, I was able to see a little of both tables when I first began using decompression traction. For me, the journey into using decompression was very personal. In 2008 I developed a disc herniation that really caused a big issue. I can first hand identify with patients who have this kind of injury. It really is painful and it really does make you wonder if anything can take the pain away. My personal experience caused me to begin a very busy 5-year journey to visit some of the largest volume decompression clinics and doctors treating disc injuries in the US. The one thing that was evident when talking to these doctors is that there was a reputation on the line and they would not imagine treating with anything less than a top-quality table. I have spoken to some doctors who lead the field that does point out that it is the act of getting a negative pressure inside the disc that gets the results, not the brand of the table. They are very right. But the computer, sensors, motor, and adjustable tabletop can vary wildly. If you are going to invest 4-12 weeks of your life to try to regain hydration and decrease bulging of a disc, you might want to really look at both the equipment as well as the education on disc injury of the doctor standing in front of you. There are just as many if not more differences between doctors as there are equipment companies.

This article was provided by a top-rated Gresham chiropractor, Dr. Westley Kuns. To learn more, you can visit his website; www.kunschiropractic.com