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CONCLUSIONS FROM THE EVOLUTION OF THE SYMPTOMS IN A PATIENT WITH CONGENITAL SPINAL STENOSIS, TREATED CONSERVATIVELY 9 YEARS BEFORE BY ABBREVIATED MEASURED VERTICAL TRACTION



Abstract

Abbreviated Measured Vertical Traction (Abbr.M.V.T.) allayed the symptoms of patients showing contained disc herniation, degenerative spondylolisthesis, disc resorption(3). This modality uses a single strong stretch on the suspended patient, contrary the weak stretches repeatedly applied by the regular lumbar traction. In spite of the different diagnoses the above patients post-traction showed uniform palliation, leading the authors speculate that a single common mechanism produced their symptoms.

The submitted patient with congenital spinal stenosis had chronic bizarre symptoms and neurologic signs disabling him. In 2/04/1998 was treated by Abbr.M.V.T. Sudden relief and unexpected recession in his symptoms was reported immediately post-traction, allowing free activity. Symptoms receded soon after, disappearing in a few months and since then never until now disturbed him.

Structural features and venous hypertension are the causes of symptoms in patients with spinal congenital stenosis (2). In the submitted patient the immediately post-traction cessation of symptoms despite unchanging structural features suggests that features alone might not be the cause of symptoms.

The post-traction cessation of symptoms would suggest missing venous hypertension. Does that mean that Abbr. M.V.T. had extinguished venous hypertension? This is an hypothesis, because reduction of the hypertension seems a weak possibility in view of a disturbed venous anatomy of the root canal (1) of several years’ existence.

Evolvements indicate a more likely hypothesis would be to attribute the cessation of pain to the exchange of fluids occurring during Abbr.M.V.T. (3), able to remove the accumulated noxious chemicals producing symptoms by irritating nociceptive nerve endings.

Correspondence should be addressed to Mr J. O’Dowd, Honorary Secretary at SBPR c/o BOA, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE.

References:

1 Hoyland J A, Freemont A J, Jayson M I V. Intervertebral foramen venous obstruction. Spine14 ; 558–568, 1989. Google Scholar

2 Kirkaldy-Willis W H, Burton Ch. Managing Low Back Pain. 3rd ed., Ch 9, pp. 141–142, Churchill Liv-ingstone, New York, 1992. Google Scholar

3 tamatiadis A.Y., Istamatyadis Y Th. Resistant nerve root symptoms of patients not reporting significant history of trauma can be managed by Abbreviated Measured Vertical Traction. J Musculoskeletal Res5 (No 3): 205–215, 2001. Google Scholar