Intervertebral Differential Dynamics Therapy

Introduction

Many treatments for spine-related musculoskeletal disorders (neck or low back pain) have been developed in the healthcare field. This corresponds to a rapidly increasing burden of back-related disability [1]. Among the many approaches available to manage these conditions Surgery and physical therapy remain the most popular practices in the world [2] [3]. Initially, the best and only acceptable way to address a patient’s condition is the use of multiple opioids and steroids [4]. Surgery becomes next step for more severe patients example regardless of its obvious complications and economic costs [5]. At this point, adjunctive therapy and physical therapy become the focus for the management of spine-related musculoskeletal disorders [6][7]. Opioids and surgery may still be effective; nonetheless, emergence of nonsurgical chiropractic Decompression techniques such as intervertebral differential dynamics (IDD) offer a safer and cost-effective breakthrough for patients with spine-related conditions [8] [9] [10] [11]. The main reasons for advocating for IDD treatment are:

1. Chronic neck and back pain is a leading cause of disability
2. Opioid painkillers are on the rise in the U.S. and the rest of the world
3. Most patients prefer to avoid surgical risks or have spine-related musculoskeletal disorders for which surgical intervention is contraindicated
4. Compared to surgery, IDD is less expensive, safer, and
5. The computerized system of the IDD appears to produce consistently repeatable and measurable non-surgical decompression, as evidenced by radiology [12][13]

Definition

Simply put, Intervertebral Differential Dynamics (IDD) refers to the decompression of intervertebral segments for different spinal levels through dynamic traction and longitudinal mobilization. It is a precise and powerful form of advanced spinal decompression therapy used to open disc spaces Targeting the vertebrae to relieve pain due to disc compression and degeneration [14] [15]. Intervertebral Decompression Dynamic Therapy (IDDT) is the latest incarnation of non-surgical spinal decompression therapy that involves spinal stretching on IDD treatment equipment and is designed to relieve neck pain or back pain [16] [17]. It is a non-invasive spinal rehabilitation treatment developed by Norman Shealy, designed by a group of medical practitioners including neurosurgeons, physical therapists, orthopedists, and other healthcare practitioners, and delivered by Accu-SPINA® Spine Nursing device in an attempt to improve the efficacy of spinal pain management [18]. The U.S. Food and Drug Administration has cleared and approved the Accu-SPINA® Spine Care as a Class II medical device [9]. Patients with neck or back pain who have at least postponed other treatment options Three (3) months is usually the best option for this therapy [19]. It remains the most significant advancement in the treatment of neck or back deformities associated with persistent pain.

IDD Therapy involves a group of computer-controlled physical therapy sessions to heal or repair damaged structures in the cervical and lumbar discs and facet joints in 20 sessions of 25 to 30 minutes each, spread over six weeks [18]. The IDD device (Figure 1) delivers computer-controlled static intermittent and cyclic forces precisely delivered to gently disperse the targeted injured spinal segment, thereby creating negative intradiscal pressure to facilitate contraction or repositioning of bulging or herniated discs material and lower pressure in the disc in order to use reduced pressure to flow healing nutrients into the disc [16] [17]. The creation of negative intradiscal pressure is the main differentiating factor between IDD therapy and traditional traction therapy.

Figure 1 Accu-Spina (North America Medical, Atlanta, GA, USA) equipment for IDD treatment at the Astella Physiotherapy Clinic in southeast Enugu, Nigeria.

This pressure is offloaded from specific injured discs and nerves while tight muscles and stiff ligaments are gently stretched, reducing the size of herniated discs and improving pain, depression, straight leg raises (SLRs) and disability [12][14][18]. Spinal decompression techniques for IDD treatment consist of high tension and low tension, with low tension kept above zero to maintain controlled tension during treatment (Figure 2). Therapeutic sinusoidal waveform details decompression pressure is a slowly applied non-linear pull to the Golgi tendon organ, allowing it to fire while inhibiting increases in muscle tone. Thus, this allows the muscle to remain relaxed while lengthening [20]. Notably, the patented oscillatory capabilities offered by IDD Therapy are Usually at the “point of maximum joint distraction” [21]. Furthermore, clinicians can properly and adequately review and revise each session on the IDD treatment device, as every aspect of the session is recorded and adjusted [16] with measurable results. traditional However, traction is limited in delivering these aforementioned benefits.

Specific Features

1. Computerized and personalized programs based on patient pathology
2. Mobilization and manipulation of different spinal segments to induce negative intradiscal pressure
3. Designed to provide static intermittent and cyclic oscillatory forces
4. Forces are applied to different discs with variable directional frequency and amplitude [16]

Figure 2.

Therapeutic Effects

1. Comfortably re-educate (stretch and work) support soft tissues to increase joint range of motion
2. Distract and mobilise the facet joints
3. Opens the disc space to create a pressure differential for fluid exchange (promotes diffusion of oxygen water and nutrients to the disc area, rehydrates degenerated discs stimulates metabolism and promotes disc healing)
4. Creates negative pressure to promote disc herniation retraction and relieve pressure on nerves
5. Realigns the structure of the spine and repairs damaged intervertebral discs
6. Endorphins are released to relieve pain and reduce stress, which makes the treatment session so comfortable and calming
7. Provides a passive movement element to reduce muscle spasms
8. Provides an environment for the body to repair itself. [16][18][17]

Figure 3.

Indications

1. Herniated or bulging discs
2. Degenerative disc disease
3. Sciatica
4. Facet syndrome
5. Cervical radiculopathy
6. Chronic low back and neck pain

(according to IDD device manufacturer’s agreement/recommendation)[12]

Contraindications

1. Cauda Equina Syndrome
2. Spondylolithesis (Grade II or higher)
3. Spondylolysis
4. Osteoporosis (T-score greater than -2.5)
5. Spinal surgery (less than six months)
6. Surgical hardware in the spine
7. vertebral fracture (less than six months old)
8. Patients less than 18 years
9. Pregnancy
10. Postpartum (less than six months)
11. Metastases
12. Congenital spinal abnormalities
13. Rotatory or severe scoliosis
14. Pacemaker

(according to IDD device manufacturer’s agreement/recommendation)[12]

Treatment Protocol

IDD treatment consists of different treatment sessions lasting 25 to 30 minutes designed for each patient [16]. Its protocol allows controlled distraction of the target vertebra to mobilize the joint and create negative pressure within the intervertebral disc [18]. A session of IDD treatment is usually Targeted exercises or manual therapy or a 10-minute far infrared treatment on the affected area (neck or back) to increase blood circulation. After the session, a 10-minute cold session is often recommended to reduce soreness. In its best interest, manufacturers of IDD equipment Twenty IDD sessions, 3 to 5 sessions per week for 6 to 8 weeks, are recommended for patients with neck or back pain.

Outcome Measures

Clinicians can monitor treatment progress using the IDD device’s built-in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) outcome measures

Previous Studies on IDD Therapy

There are documented outcomes regarding therapeutic goals achieved with IDD devices. Shealy [22] reported an average pain reduction of 65% and 76% in Americans with low back pain after IDD treatment and one year after IDD treatment. McClure and Farris [18] examined 415 accepted In the IDD treatment plan, treatment success was measured by a greater than 50% reduction in mean pain scores at 2 months and 2 years. A double-blind randomized controlled trial by Demirel et al. [23] from this perspective answers one of the most common questions about IDD whether non-surgical spine Stress reduction therapy varies in the treatment of spinal dysfunction. Demirel et al. [23] reported that the study group (patients receiving standard care and IDD treatment) had significant reductions in pain levels, functional recovery, and reduction in hernia thickness compared to the control group (only those receiving standard care). Standard care was defined as receiving electrotherapy stabilization exercises and friction massage.

Schaufele and Newsome [24] concluded in their study of patients with symptomatic lumbar degenerative disc disease that IDD therapy provided similar clinical improvement compared to exercise-based physical therapy. The first IDD treatment study in Africa by Ekediegwu and colleagues [25] showed that IDD therapy significantly reduces VAS-measured low back pain when combined with physical therapy modalities. In addition, the efficacy of IDD therapy combined with traditional conservative treatment has been further confirmed and strongly recommended [12][26][27][28]。