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Article Dans Une Revue Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine Année : 2021

Relevance of a novel external dynamic distraction device for treating back pain.

Résumé

Low back pain is a common, expensive, and disabling condition in industrialized countries. There is still no consensus for its ideal management. Believing in the beneficial effect of traction, we developed a novel external dynamic distraction device. The purpose of this work was to demonstrate that external distraction allows limiting the pressure exerted in standing-up position on the lower intervertebral discs. Numerical and cadaveric studies were used as complementary approaches. Firstly, we implemented the device into a numerical model of a validated musculoskeletal software (Anybody Modeling System) and we calculated the lower disc pressure while traction forces were applied. Secondly, we performed an anatomical study using a non-formalin preserved cadaver placed in a sitting position. A pressure sensor was placed in the lower discs under fluoroscopic control through a Jamshidi needle. The intradiscal pressure was then measured continuously at rest while applying a traction force of 200 N. Both numerical and cadaveric studies demonstrated a decrease in intradiscal pressures after applying a traction force with the external device. Using the numerical model, we showed that tensile forces below 500 N in total were sufficient. The application of higher forces seems useless and potentially deleterious. External dynamic distraction device is able to significantly decrease the intradiscal pressure in a sitting or standing position. However, the therapeutic effects need to be proven using clinical studies.
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Dates et versions

hal-03138340 , version 1 (11-02-2021)

Identifiants

Citer

Fahed Zaïri, Mélissa Moulart, Christian Fontaine, Fahmi Zaïri, Vincent Tiffreau, et al.. Relevance of a novel external dynamic distraction device for treating back pain.. Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine, In press, ⟨10.1177/0954411920971401⟩. ⟨hal-03138340⟩
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