Changes in the Sagittal Cranio-Cervical Posture Following a 12-Week Intervention Using a Simple Spinal Traction Device.

STUDY DESIGN: Non-controlled clinical trial.

OBJECTIVE: To assess the efficacy of a simple home spinal traction device on sagittal cranio-cervical posture and related symptoms.

SUMMARY OF BACKGROUND DATA: Forward head protraction (FHP) and cranio-cervical malalignment were shown to be consequential in the development adverse musculoskeletal radiographic findings and symptoms in that region.

METHODS: Participants (n = 13, 18-36-year-old) were drawn from a mildly symptomatic population, all presented with cranio-cervical malalignment and considerable FHP. Participants used a simple home spinal traction device for 12 weeks, 10 min/d. Sagittal cervical radiographs and the SF36 health survey were obtained pre/post intervention and guideline compliance was recorded. Radiographic evaluation included typical measurements of sagittal cranio-cervical alignment and FHP (e.g., atlas plane line, vertical axis line, sagittal cranial angle, absolute rotation angle). Standard paired samples t tests, chi-squared, and effect size analyses were used to assess pre- and post-intervention changes.

RESULTS: Each of the key radiographic variables recorded significant moderate to very large positive changes as a result of the intervention. Similarly, Chi-squared analyses indicated that saggital cervical spine configuration tended to become more lordotic (P = 0.007), with four participants shifting from a kyphotic to a lordotic presentation. SF36 health survey data demonstrated mostly significant positive changes throughout all tested domains, and moderate positive changes were recorded across all radiographic cranio-cervical mesured paramenters (e.g., decreased FHP, increased cervical lordosis, and cranial extention). Participants indicated high level of protocol compliance.

CONCLUSION: This study has demonstrated that the unsupervised daily use of a simple home spinal traction device (Thoracic Pillow) proved effective in bringing positive plastic changes to the sagittal cranio-cervical alignment and reduction in symptoms in the tested population during a short intervention period.

LEVEL OF EVIDENCE: 3.