Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study

1 Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA
2 Upper Valley Interventional Radiology. McAllen, Texas, USA
3 NEMA Research, Inc, Biomedical Research & Education Foundation, LLC, Miami Beach, FL, USA
4 Departments of Anesthesia and Health Research and Policy, Stanford University, Palo Alto, California, USA
5 Department of Medicine, Johns Hopkins University, Baltimore, Maryland, & Department of Anesthesia, Georgetown University School of Medicine, Washington, DC, USA

http://www.biomedcentral.com/1471-2474/11/155

Received: 14 October 2009
Accepted: 8 July 2010
Published: 8 July 2010
Abstract
Background
Because previous studies have suggested that motorized non-surgical spinal decompression can reduce chronic low back pain (LBP) due to disc degeneration (discogenic low back pain) and disc herniation, it has accordingly been hypothesized that the reduction of pressure on affected discs will facilitate their regeneration. The goal of this study was to determine if changes in LBP, as measured on a verbal rating scale, before and after a 6-week treatment period with non-surgical spinal decompression, correlate with changes in lumbar disc height, as measured on computed tomography (CT) scans.
Methods
A retrospective cohort study of adults with chronic LBP attributed to disc herniation and/or discogenic LBP who underwent a 6-week treatment protocol of motorized non-surgical spinal decompression via the DRX9000 with CT scans before and after treatment. The main outcomes were changes in pain as measured on a verbal rating scale from 0 to 10 during a flexion-extension range of motion evaluation and changes in disc height as measured on CT scans. Paired t-test or linear regression was used as appropriate with p < 0.05 considered to be statistically significant.
Results
We identified 30 patients with lumbar disc herniation with an average age of 65 years, body mass index of 29 kg/m2, 21 females and 9 males, and an average duration of LBP of 12.5 weeks. During treatment, low back pain decreased from 6.2 (SD 2.2) to 1.6 (2.3, p < 0.001) and disc height increased from 7.5 (1.7) mm to 8.8 (1.7) mm (p < 0.001). Increase in disc height and reduction in pain were significantly correlated (r = 0.36, p = 0.044).
Conclusions
Non-surgical spinal decompression was associated with a reduction in pain and an increase in disc height. The correlation of these variables suggests that pain reduction may be mediated, at least in part, through a restoration of disc height. A randomized controlled trial is needed to confirm these promising results.
Clinical trial registration number
NCT00828880
Background
An estimated 80% of the population will suffer from low back pain (LBP) at some point of their lives[1]. Low back pain is the number one factor limiting activity in patients less that 45 years old, the second most frequent reason for doctor’s visits, and the third most common cause for surgical procedures[2]. In addition to imposing upon patients’ quality of life, LBP is of significant socioeconomic relevance because it may lead to a temporary loss of productivity, enormous medical and indirect costs, or even permanent disability[3].
While the management of persistent low back pain remains hotly debated, the traditional approach has been non-surgical treatment with analgesia supplemented by physiotherapy. Given the limited efficacy of these modalities, there are also a number of alternative interventions such as massage, spinal manipulation, exercises, acupuncture, back school and cognitive behavioral therapy[4]. The two most common diseases involving chronic LBP are discogenic low back pain, responsible for 39% of cases, and disc herniation, accounting for just less than 30% of LBP incidence. These incidence frequencies are supported by the current data that most closely link the clinical pathology of discogenic low back pain and disc herniation to the anatomical structure of the intervertebral disc. Thus, another treatment option is motorized decompression, a technique designed to lessen pressure on the discs, vertically expand the intervertebral space, and restore disc height[5-7]. However, systematic reviews to date were unable to find sufficient evidence in the literature to support the use of this modality[8,9]. A subsequent chart review of 94 patients suggests that motorized non-surgical spinal decompression may be effective in reducing chronic low back pain[10]. Furthermore, preliminary data from a prospective cohort study in patients with chronic low back pain reported a median pain score reduction from 7 to 0 (on a 11-point verbal rating scale) following a 6-week non-surgical spinal decompression treatment protocol[11].
The goal of this study was therefore to determine if changes in LBP, as measured on a verbal rating scale, before and after a 6-week treatment period with motorized non-surgical spinal decompression, correlate with changes in lumbar disc height, as measured on computed tomography scans.
Methods
Study design
This is a retrospective cohort study of patients who underwent a 6-week treatment protocol of non-surgical spinal decompression via the DRX9000. A HIPAA (Health Insurance Portability and Accountability Act) waiver was obtained through Quorum IRB. This waiver permitted a review of medical records and access to CT scans ordered as part of standard of care.
Clinical Trial Registration Number: NCT00828880
Inclusion and exclusion criteriaPati
ents and their medical records were eligible for inclusion if the patient was at least 18 years of age, consented for the 6-week treatment protocol, and presented with chronic LBP of at least 3 out of 10 on a verbal rating scale and was due to either discogenic LBP or disc herniation according to a radiological diagnosis using standard medical definitions. Discogenic LBP is most succinctly defined as a loss of lower back function with pain due to disc degeneration. Degenerative disc diseases often emerge when abnormal stresses cause the nucleus gelatinosus to unevenly distribute weight, the annular fibrosis and end plate incur structural damage, and a destructive inflammatory response is triggered to accelerate and perpetuate the degeneration of the disc. A herniated disc (synonymous with a protruding or bulging disc) arises when the intervertebral disc degenerates and is weakened to such an extent that cartilage is pushed into the space containing the spinal cord or a nerve root and causes pain[1].
All patients were treated at the Upper Valley Interventional Radiology facility (McAllen, Texas). Patient symptoms were evaluated by medical history review, physical examination, and a current CT scan (not older than 2 months prior to the start of treatment) to support a diagnosis of chronic discogenic LBP due to bulging, protruding or herniated intervertebral discs that may have been brought on by degenerative disc disease. Patients were only included if pre- and post-treatment CT scans were performed on the same device, measurements taken by the same investigator (WM), and data recorded on standard collection forms. One height measurement was taken by WM for each of the intervertebral discs under study per CT scan. Accuracy of data was confirmed by a second investigator (JP), but only one measurement was made of each intervertebral disc per CT scan. All CT scans analyzed were performed at least one hour after the subject got out of bed. The first CT scan was performed within two months before the initiation of the treatment, and the second CT scan at least one day after or on the day immediately before the final treatment session.
Exclusion criteria for enrollment in the study were any patients with metastatic cancer; previous spinal fusion or placement of stabilization hardware, instrumentation or artificial discs; neurologic motor deficits; bladder or sexual dysfunction; alcohol or drug abuse; or litigation for a health-related claim (in process or pending for workers’ compensation or personal injury). Limitations of the spinal decompression system also led to the exclusion of patients with extremes of height (< 147 cm or > 203 cm) and body weight (> 136 kg).
Treatment protocol
Patients received treatment with the DRX9000 (Axiom Worldwide, Tampa, FL) as dictated by the intervention’s operating guidelines[11]. In short, the protocol typically included 22 sessions of spinal decompression over a 6-week period with 28-minute active treatment sessions. At the start of each session, the patient is fitted with adjustable lower and upper body harnesses and is lowered into the supine position. To initiate active treatment the machine then pulls the patient gently on the lower harness while the upper harness remains stationary, thus distracting the patient’s spine. A safety button can be pushed at any time by the patient to release all tension immediately. Daily treatments, Monday through Friday, were performed for the first two weeks of treatment. The latter four weeks consisted of treatments every other day, Monday, Wednesday and Friday.
Initial decompression force was adjusted to patient tolerance, starting at 4.54 kg (10 lbs) less than half their body weight. If a patient described the decompression pull as “strong or painful,” this distraction force was decreased by 10%-25%. In subsequent treatment sessions, the distraction force was increased as tolerated to final levels of 4.54 kg to 9.07 kg (10 to 20 lbs) more than half their body weight. Patients continued to use analgesics prescribed by their physicians before enrollment, but were allowed to use additional non-steroidal pain medication should their pain increase temporarily and permitted to discontinue pain medication as needed. During the routine physical examination performed by WM prior to beginning the non-surgical spinal decompression treatment session, at the first and final visits maximal pain was evaluated during a flexion-extension range of motion exam with the question “How strong is your pain on a scale of 0-10 with 0 being no pain and 10 as bad as it could be?”
Variables
The first main outcome for this study was the change in pain during a range of motion evaluation measured on an 11-point verbal rating scale (VRS), with 0 being no pain and 10 being pain as excruciating as could be imagined, before and after the 6-week spinal decompression treatment regimen.
The second main outcome was the change in average disc height as measured by CT scan. For each patient, average disc height of L3-L4, L4-L5 and L5-S1 was calculated before the first treatment session and at least one day after or on the day before the last treatment session.
Statistical analysis and sample size estimation
We assumed data to be normally distributed unless exploratory analyses suggested otherwise, in which case a Kolmogorov-Smirnov test was to be applied. Since the treatment effect was defined as the difference between before and after the therapeutic intervention, a paired t-test was applied to test whether there was a reduction in pain and an increase in disc height. For the main hypothesis, the correlation between disc height changes and low back pain, we applied linear regression to quantify the relationship with Pearson’s correlation coefficient to determine statistical significance.
Sample size estimations were performed to have sufficient power to test with a two sided type I error of 0.05 and type II error of 0.2 (80% power). Given the sizeable treatment effect reported in the retrospective chart review and also in the prospective pilot study mentioned in the introduction, we expected a reduction in range of motion pain from 6 to 2, with a standard deviation of 2.5. This resulted in a sample size estimation of only 5 patients. To test changes in disc height, we expected a standard disc height of about 8 mm with diseased discs being slightly more compressed, i.e. at about 7.5 mm, and anticipated discs after the decompression treatment to measure at about 8.25 mm. Assuming a standard deviation of 1.0 mm, we estimated a required sample size of 16 patients in order to show a difference. The sample size for the main hypothesis, that the degree of pain reduction is associated with the amount of increase in disc height, was more difficult to estimate since no previous study had determined a correlation coefficient. Therefore, we chose a coefficient of 0.5 for a conservative expectation, resulting in a required sample size of 26 patients. Taking into consideration the possibility of drop-outs, we aimed to collect data from 30 patients.
Results
During a two year period, Sept 19, 2005 to Aug 6, 2007, a total of 103 patients were treated with the intervention, but only 30 of those patients fulfilled the per protocol inclusion and exclusion criteria for the analysis. The 30 participants consisted of 21 female and 9 male patients with lumbar disc herniation. They had a mean (SD) age of 65 (± 15) years, a body mass index of 29 (± 5) kg/m2, and an average duration of LBP of 12.5 (± 19) weeks with a score of 6.3 (± 2.2) on the VRS (Table 1). All 30 patients had a disc prolapse and the majority (n = 25) also had degenerative disc disease.
Table 1. Patient characteristics
The maximum force during the first treatment was on average 33.9 (± 6.8) kg and gradually increased during subsequent treatment visits to 52.4 (± 7.6) kg (Table 2).
Table 2. Treatment characteristics and outcome
Low back pain decreased from 6.2 (± 2.2) to 1.6 (± 2.3, p < 0.001) and disc height increased from 7.5 (± 1.7) to 8.8 (± 1.7) mm (p < 0.001) (Figures 1 and 2).
Figure 1. Increase in disk height before and after the non-invasive spinal decompression treatment protocol.
Figure 2. Pain reduction before and after the non-invasive spinal decompression treatment protocol (because several lines overlap, there are less lines than subjects).
There was a statistically significant correlation between the increase in disc height and a reduction in pain (r = 0.36, p = 0.044), with a 1 mm increase in disc height being associated with a reduction of 1.86 on the 11-point verbal rating scale (Fig. 3). No adverse events were reported during the treatment period.
Figure 3. Correlation between increase in disk height and decrease in pain.
Discussion
In this cohort study we extracted data from 30 patients with discogenic low back pain and found an average reduction in pain from 6.2 to 1.6 after non-surgical spinal decompression. This level of pain relief is consistent with two previous studies using DRX9000 to decrease chronic low back pain[10,11]. However, here we systematically investigated the change in disc height before and after the treatment, and were able to show that increases in disc height correlated with increased pain relief. A mechanical explanation for this correlation might be that the non-spinal decompression reduces the pressure on the discs. This relief of stress would simultaneously promote regeneration of diseased and compressed discs and increase lumbar disc height, with the latter reducing load on the facet joints.
It is well recognized that continuous pressure on vertebral discs decreases their height. Humans are taller in the morning after the discs decompress while the body is supine overnight and shorter in the evening after the discs have borne weight during daily activity[12]. Interestingly, this effect occurs quite rapidly so that the majority of height-loss in a day occurs within the first hour of arising. Therefore, all CT scans analyzed in this study were performed at least one hour after the subject got out of bed. The first CT scan was performed within two months before the initiation of the treatment and at least one day after or the day immediately before the final treatment session.
A clear diagnosis cannot be made in approximately 80% of cases of LBP, and imaging techniques can only offer a partial solution to the problem of making a causal diagnosis of LBP[13]. One might argue that a CT scan is not as sensitive a measure of disc height as an MRI scan because it images soft tissues poorly and cannot examine internal disc morphology. However, because the primary objective was to establish an observable correlation between disc height increase and decreased LBP, a CT scan permitting examination of the outline of the intervertebral discs at high resolution provided sufficient measurable evidence[14].
It has been demonstrated that low back pain can lead to muscle spasms that could directly perpetuate pain,[15] or induce pain within the disc as nerve fibers have been described to grow into the inner part of the annulus fibrosus or nucleus pulposus[16]. It is hypothesized that the pain-spasm-pain cycle[15] is perpetuated by further reduction in disc height, which also simultaneously aggravates the facet joint. In either case, dampened pressure on the disc should facilitate the regeneration of the disc and assuage facet joint stress. In fact, it has been described that non-surgical spinal decompression mechanically creates negative intradiscal pressures, and it is speculated that this supports disc regeneration, though this remains controversial[5].
Pain measurement relies first and foremost on patient report. Taking into account the subjectivity inherent in this process, it was noted that a cut-off point, or rather the change in pain score necessary for detecting a clinically important difference in an individual patient, was needed to identify responders and non-responders to analgesia. Farrar et al reported that on average a reduction in pain intensity of at least 2 points on the NRS serves as a clinically significant change[17]. Using this standard, in this cohort study this intervention had a success rate of over 75% (pain decreased by more than 2 out of 11 in 23 out of 30 patients). In our analysis, each millimeter of increase in disc height was associated with pain relief of roughly 2 points on the scale, a clinically important difference according to the aforementioned report.
However, not all patients responded equally. This raises the question of inter-individual variability and might be addressed by taking into account the heterogeneity of lumbar spine muscle strength acting as a counterforce to the external distraction. Even though the DRX9000 machine has an integrated sensor to detect counterforces, non-surgical spinal decompression can only work if lumbar spine muscles are relaxed. Another reason for different inter-individual response rates could be the age of the patients. However, in sub-analyses (not described) we did not find a correlation between age and treatment success. With regards to the elderly cohort of patients analyzed in this retrospective study, it is possible that a younger patient population might respond differently to the non-surgical spinal decompression treatment given that they would generally have less disc degeneration, be more active, and have less co-morbidity than the elderly population studied here. Yet this is a hypothesis that remains to be tested in a future prospective study investigating therapies to alleviate LBP in younger patients. While we largely believe the range of muscle tone during non-surgical spinal decompression to be the main reason for different treatment effects, other reasons for variability could be differing stages and degrees of degenerative disc disease, an assortment of activity levels, and a wide spectrum of concomitant treatments ranging from chiropractic interventions and pain medication cocktails.
One limitation of this study is the lack of a control group. This is especially relevant for herniated discs, because of the significant rate of spontaneous recovery[18,19]. A control group would have been absolutely necessary if the primary objective was to establish a causal relationship proving that the increase in disc height is due to the non-surgical spinal decompression; however, our primary objective was rather to demonstrate the correlation between increased disc height and reduction of pain. Thus, irrespective of a control group, this is the first study that provides evidence of an association between an anatomical correlate, change in disc height, with pain relief over time. Even so, it is possible the placebo effect may have contributed to the perception of having decreased pain. Given that the correlation between the increase of disc height and the reduction of pain shows an r2 = .13, while statistically significant, there is room for an argument suggesting that perhaps the placebo effect played a role in the positive outcome. Both limitations of the current retrospective study indicate the need for a randomized placebo-controlled trial to establish a more concrete relationship between the anatomical disc changes attributed to the non-surgical spinal decompression intervention and the reduction of LBP.
Patients with chronic discogenic low back pain are usually on a wide range of analgesics, and pain and analgesic consumption is generally positively correlated. As a result, interventions that reduce pain typically lead to a reduced consumption of analgesics and thus counteract the treatment effect of the intervention (suppressor effect). The fact that a significant reduction of pain was observed even though analgesics were not controlled for corroborates the observation of pain relief through non-surgical spinal decompression.
Finally, the follow-up period was too short to comment on the permanency of pain relief. However, this was not within the scope of this study and the duration of the effect is not essential to substantiate our primary finding that restoration of disc height through non-surgical spinal decompression is associated with decreased discogenic low-back pain. The next step will be to obtain long-term results, e.g. 1 or 2 years after the last treatment cycle, to a) investigate whether treatment effects are long lasting and to b) more importantly, establish whether there is a long term correlation between disc height increase and pain reduction.
Conclusions
In this study of non-surgical spinal decompression for chronic discogenic low back pain we were able to demonstrate an association between the restoration of disc height and pain relief. The correlation of these variables suggests that pain reduction may be mediated, at least in part, through a restoration of disc height. These results call for a randomized placebo-controlled trial to substantiate the efficacy and elucidate the mechanism of this promising treatment modality.
Competing interests
The authors themselves declare that they have no competing interests.
NEMA Research is a Clinical Research Organization that is involved in evidence-based research development and was the lead sponsor implementing the protocol for this clinical trial on behalf of Axiom-Worldwide.
Authors’ contributions
CA contributed to the statistical analysis and drafting the manuscript, OSC contributed to the statistical analysis of the data, WM is responsible for the assessments made, data collection, and data review, CR performed statistical analysis and assisted with writing the manuscript, AM assisted with drafting the manuscript, EG contributed to drafting, editing, and formatting the manuscript, MS contributed to drafting and editing the manuscript, JVP performed the data review. All authors read and approved the final manuscript.
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Many people develop a herniated or bulging disc in their spine. Injury, aging, and poor lifestyle choices are common causes of a disc problem. While a mild degree of a “bulge” may be considered normal, there are a number of different types of disc injuries that are not normal and create a great deal of pain. In severe cases, muscle atrophy, pain and numbness, can be present. When these problems exist, symptoms will show up in the lower back/legs, or arm and hand. Below, several common questions about disc problems are answered and discussed.

Do discs slip?
In lay terms, a slipped disc can mean a ruptured disc or herniated disc. Although the term slipped disc is used, discs do not actually slip. Each intervertebral disc is sandwiched between two vertebrae supported by a system of very strong ligaments that help hold the spinal package together.

What is the difference between a bulging and herniated disc?
Disc disorders are contained or non-contained. A bulging disc is an example of a contained disc disorder. A bulging disc has not broken open; the nucleus pulposus (the center section) remains contained within the anulus fibrosus (the outer layer). A bulging disc could be compared to a volcano prior to eruption and may be a precursor to herniation. The disc may protrude into the spinal canal without breaking open. The gel-like interior (nucleus pulposus) does not leak out. The disc remains intact except a small bubble pops out attached to the disc. A very simple example is a jelly doughnut. If you step on the doughnut with a lite amount of force, the jelly causes the dough to push, or “bulge” out; yet, the jelly does not leak outside the dough.

A non-contained disc is one that has either partially or completely broken open; a herniated or ruptured disc. To illustrate imagine a tube (anulus fibrosus) of toothpaste (nucleus pulposus) placed under pressure. The pressure causes the toothpaste within the tube to move wherever it can. If any part of the tube is weak toothpaste may leak out. When a disc herniates the contents may spread out to the spinal cord and nerves. The disc material has very little space to go. Usually, the disc material enters into the area occupied by the spinal canal and nerve roots. When this occurs, a number of problems will be present, starting with moderate to severe pain. Using the example of the jelly doughnut again, in this case, when stepping on the doughnut, the jelly actually breaks through the outer dough and leaks out.

Why might a herniated disc cause pain?
When the disc bulges or herniates, material from the disc puts pressure onto the nerve root or spinal cord. This pressure, onto the nerve, is what causes the pain in either the arms or legs. To complicate matters, sometimes fragments from the anulus (tire-like outer disc wall) break away from the parent disc and drift into the spinal canal. These free fragments may travel into the spinal canal. This can be a more serious condition, such as Stenosis. Depending on the type of injury and the condition of the discs, more than one disc may herniate, rupture, or bulge. Sometimes injury causes a combination of disc disorders. In and ideal situation, the problem may resolve in the first 60-90 days after the injury. However, when the problem persists over 90 days, the chance of it resolving on its own is slim.

Degenerative Disc

If an individual undergoes a number of injuries, or has abnormal wear and tear on a disc, it is possible to have degeneration. Degeneration of a disc is when the disc size and material, get thin and start to break down. When this occurs, the space between the two involved vertebrae gets smaller, closing down the foramen(hole) where the nerve root exits the spinal cord. This condition can cause a nerve to have pressure on it and create pain.  Additionally, there tends to be changes to the bone that occur in these cases. These changes come in the form of bone spurs or osteophytes, which create their own set of problems.  Some think that degeneration is normal with age, and to a degree this is true. However, when an individual has degeneration at one level or disc, and the rest are healthy, then this is not normal. Generally this is caused from an injury, or series of injuries, in which permanent damage was done, or proper treatment was not done after the injury.

Sciatica is pain running down your leg in a pattern determined by the sciatic nerve. The pain often starts in the low back – (due to a herniated disc) – or in the buttock – (due to piriformis syndrome) – and extends as far as your toes. It can be accompanied by numbness, ‘pins and needles’ (“paresthesias”) or, in more severe cases, actual weakness affecting the ankle or toes may accompany the sciatica.

Sciatica is a form of pain that is called a “radiculopathy” in medical terminology. This means that it often follows the path of a single spinal nerve root such as the Lumbar 5 (L5) or Sacral 1 (S1). This is often the case when sciatica is due to a herniated disc or bulging disc. If the cause is in the lumbar spine, the sciatica – or leg pain – is often accompanied by back pain.

When the sciatica symptom is due to a herniated disc, it often affects a single strip of skin or dermatome. A far lateral herniated disc affects the exiting nerve root and is compressed by a lateral disk herniation. More commonly, however, the disk bulge is close to the body’s midline. The patient’s detailed distribution of symptoms must match exactly with the MRI findings in the spine before treatment plan can be recommended.

Sciatica Terms and Conditions:

• Sciatica and pregnancy – The symptom of sciatica can be triggered during pregnancy for three reasons. The added weight and bending stress on the spine can worsen a bulging disc. The expanded uterus in the pelvis can press on some the lumbar and sacral spinal nerves that help form the sciatic nerve. Additional stresses from the weight of the pregnancy can trigger a piriformis syndrome.

• Sciatica and Back Pain – Radiating pain down the leg often occurs along with back pain, however, the two symptoms are not always linked. A herniated disk will occasionally cause buttock and leg pain with virtually no back pain. When you have back pain alone but no sciatica, then your problem may be something other than a herniated disk. Back pain alone can even have it’s roots in life stress, however sciatica is almost always an indication of a specific nerve related problem.

Sciatica Treatment: When Sciatica is due to a Disc problem, the only form of treatment that has proven beneficial is one that physically addresses the disc. While Chiropractic treatment can give temporary relief, most cases will not respond permanently. Other forms of treatment such as Physical Therapy, Massage and Accupuncture do not address the disc and can not fix the problem. These treatments can actually make you worse if you have a true disc injury.  Spinal Decompression is the safest and most effective treatment to date for Sciatica due to a Bulging, Herniated or Degenerative Disc. 

**A Bulging or Herniated Disc in the Lumbar Spine/Lower Back can cause Sciatica. However, a similar Disc Problem or injury in the Cervical Spine/Neck,  can create similar symptoms in the arms and hands.

Medical

*Why is Non-Surgical Spinal Decompression at Roseville Back Center (RBC) better for me than other surgical options or epidurals? At RBC, we use technologically advanced, non-surgical procedures to treat spinal conditions with no blood loss, no scarring, no scar tissue, no prescribed pain injections and we do not use anything to cause any potential problems such as hardware.

*What are the risks of your Non-surgical Decompression procedures? There are no risks for neck or back procedures. Our procedures are non-surgical and require no small incisions, there is no general anesthesia used which can be high risk in some patients and there is no risk of infection associated with non-surgical spinal decompression.

*I have spinal stenosis or foraminal stenosis, can I be helped? Yes, our procedures work well for these conditions. RBC can remove impingements to the spinal or forminal canal and remove pressure from the nerve, thereby relieving the pain and symptoms.

*How many SD treatments will I require to solve my back or neck pain? Back and neck pain is very individualized so treatment length is dependent upon the severity of each case. During the initial evaluation, it will be determined how many levels of damage you have that are causing symptoms. In most cases, problems are found at multiple levels, but only one or two of them may be causing symptoms. The majority of patients treat for 8-10 weeks.

*Can you help me if I have had failed back surgery? Yes, we typically can—in fact, a large number of our patients have had failed back or neck surgery in the past or have complications due to surgery. Dr. Oberti can correct most of these spinal conditions and patients frequently report they wish they did SD before ever doing surgery!

GENERAL

*What do I have to do to find out if I am a candidate for Non-Surgical Spinal Decompression? After you have completed the first step of your initial consult and exam, Dr. Oberti will review your MRI or CAT Scan and correlate them with your consult and exam findings to determine if you are a candidate for the non-surgical decompression procedure. If you are interested in a Complimentary Consultation, simply call our office and ask to meet with Dr. Oberti immediately.

*What are my limitations after SD Treatments and how long will I be out of work? Dr. Oberti recommends that a patient returns to normal activities gradually to allow maximum healing. Patients that have desk jobs can normally return to work without restrictions. Patients with physically strenuous jobs, should wait two weeks depending on their job. Our goal is to return you to your normal actvities as soon as possible.

*Why don’t more Docotors use this type of procedure? This is a sophisticated procedure and it takes many hours of learning and training. Dr. Oberti is on the cutting edge of advanced spinal procedures and non-surgical spinal decompression technology. Dr. Oberti sees this changing in the future as this will become the standard of practice for non-surgical intervention of spinal conditions throughout the world.

*Is this procedure considered experimental? No. This is a FDA cleared procedure and has been performed by certified doctors for a decade with an incredible success rate. Currently, John Hopkins, UCSF and Georgetown Medical Schools are continuing to release research artilces on the effectiveness of the DRX9000.

*Is my bulging disc or herniation going to be removed? No. In most cases we are able to open or widen the disc spaces to alleviate the pressure on the nerves without removing the disc. We now have Pre/Post MRI’s showing a reduction in bulging/herniated disc after treatment.

INSURANCE

*What are the costs of non-surgical spinal decompression procedures? Each case is different depending on the numbers of levels involved and the extent of treatment required. Upon acceptance of your case, we will verify your level of coverage for your individual benefit to clarify what your maximum responsibility will be.

Roseville Back Center
Twin Creeks Chiropractic
584 N Sunrise #130
916-781-2600

If you’re like most patients we see today, you’ve suffered from back, hip, leg or neck pain for far too long–maybe decades. And you’ve tried virtually everything–bed rest, over-the-counter medications, prescription pain killers, physical rehab, chiropractic, injections, massage, acupuncture, traction and maybe even surgery. And so far, nothing has worked. You’re still in pain. And some days, you feel like your life is never going to get any better. You will never be able to golf again, play with your grandkids, water ski, or simply bend over and tie your own shoe.

And that’s not surprising since research shows that most pain-relieving tactics and procedures aren’t effective in treating chronic back or neck pain at all – especially long term. So several years ago Dr. Anthony Oberti, DC, a Chiropractor in Roseville, CA, began to look for an alternative – something more effective, something less reliant on chemicals, and something safer and less invasive.

He found Spinal Decompression Therapy with the DRX9000 spinal decompression system. Up until that time, he had never heard of the technology – until he went to a spine conference and heard the seemingly incredible results doctors were getting from the therapy. Beginning his own research, he soon became convinced that spinal decompression was an efficacious procedure and added the therapy to the practice.

“In the last 3 years alone, our program has helped hundreds of patients. Patients that were informed they would require surgery and never be the same, are now living a normal, pain-free life, all because of Spinal Decompression!”, Dr. Anthony J. Oberti, D.C.

The fact is, most back and neck pain is caused by herniated discs, bulging discs or degenerative discs. This leads to sciatica, back pain, leg cramps, neck pain, arm pain, and a host of other symptoms. The problem has always been finding a way to treat discs without doing something invasive like surgery. Prior to spinal decompression therapy there wasn’t a step between treatments like chiropractic, physical therapy, other non-invasive options and surgery. Now there is.
Unlike other structures in your body, discs don’t have a very good blood supply, so once they’re damaged they don’t heal very well. A disc gets its nutrition from the bones above and below it through a pumping motion that increases with movement and normal motion. But once a disc is damaged or torn, it loses its ability to maintain hydration and becomes dry and brittle. This leads to further damage and usually only gets worse with time.

The DRX9000 system used at our clinic is FDA-cleared and enables a doctor or therapist to gently, precisely and safely put tension(facilitated by a computer and monitoring device)on the lower back or neck and create a negative pressure inside the disc. This negative pressure creates a vacuum effect that actually draws the bulging or “slipped” material back into the center of the disc. It also draws fluids into the disc-helping it rehydrate and heal.

Unlike other treatments for back pain and neck pain, the DRX9000 technology actually heals the discs and
makes them healthier. Most other treatments like medication and injections only cover up the pain until it wears off or you aggravate it again. Not “spinal decompression”. In a recent study done on previous spinal decompression patients 4 years after their treatment, researchers found that over 91% continued to be pain free. And don’t be fooled by cheap gimics, home traction devices or other units. Unless you can isolate the involved vertebra, and overcome muscle contraction, you will never be able to address the disc. Traction, DOES NOT do this, and no other therapy outside of spinal decompression therapy does. To learn more about how this works, sign up for a copy of our informational DVD, or call our office at 916-781-2600 for a complimentary consultation to see if you qualify for care.

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Call Roseville Back Center in Roseville CA Now at (916) 781-2630

-Herniated Discs

-Bulging Discs

-Degenerative Discs

-Sciatica

-Chronic Neck Pain

-Headaches

Please browse through the website to learn more about these conditions and how we treat, and correct, these problems. Make sure and order the FREE DECOMPRESSION DVD for more information, or call (916) 781-2630,  for a Complimentary Consultation.

“Dr. Oberti and all the staff are awesome! They are able to diagnose the problem quickly and get right to helping you feel better!” – Google Plus Review