Friday, January 18, 2008
Above are images of a cervical MRI a pre and post of a patient with a herniated cervical disc.
I recently added the brand new Cox table to my arsenal and this table has been improving patient outcomes.
Published Outcomes of the Cox technic.
The European Spine Journal published (in July 2006) the outcomes of the US Government's Health Resources & Services Administration (HRSA)-funded comparison study of chiropractic flexion-distraction care and medical conservative care for low back pain. Its findings are that
"Overall, flexion-distraction provided more pain relief than active exercise [the medical conservative approach]; however, these results varied base on stratification of patients  with and without radiculopathy [extremity/leg pain/sciatica] and  with and without recurrent symptoms."
"Patients with radiculopathy did significantly better with FD."
a herniated disc relief pain
Goals of Treatment
DISC RELATED PAIN CONDITIONS
For patients with a "slipped/bulging/ruptured/herniated" disc (without cauda equina syndrome or progressive neurological deficit), Cox® Technic provides the following benefits:
increases the intervertebral disc height (C) to remove anular tension on the anular fibers (E) and nerve (B) by making more room and improving circulation;
allows the nucleus pulposus (A) -- the center of the disc -- to assume its central position within the anular fibers (E) and relieves irritation of the spinal nerve (B);
restores vertebral joints (D) to their physiological relationships of motion;
improves posture and locomotion while relieving pain, improving body functions, and creating a state of well-being.
For patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac subluxation, stenosis), Cox® Technic provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain.
The combination of Cox Flexion distraction combined with DRX 9000 spinal decompression has been providing excellent results for my patients in my NYC practice.
1. The posterior disc space increases in height.
2. Flexion decreases disc protrusion and reduces stenosis. Note: Discs protrude and degenerate into the concavity of a curve, into the side of extension.
3. Flexion stretches the ligamentum flavum to reduce stenosis.
4. Flexion opens the vertebral canal by 2 mm (16%) or 3.5 to 6 mm more than extension.
5. Flexion increases metabolite transport into the disc.
6. Flexion opens the apophyseal joints and reduces posterior disc stress.
7. The nucleus pulposus does not move on flexion. Intradiscal pressure drops under distraction to below 100 mm Hg. On extension the nucleus or anulus is seen to protrude posterior into the vertebral canal.
8. Intervertebral foraminal openings enlarge giving patency to the nerve.
[for references for the above, see Cox JM, Feller JA, Cox-Cid JA:
Topics in Clinical Chiropractic 1996; 3(3):45-59]
Posted by Dr. Steve Shoshany at 9:15 AM