Bone remodelling after application of traction forces to the lumbar spine in women with chronic low back pain.

Abstract

Aims: The aim of the study was to investigate the effect of systematic lumbar traction, applied in 20 sessions over four weeks, on the size of vertebrae, bone mineral density (BMD), and bone turnover markers in women with chronic low back pain (LBP).

Methods: A total of 30 women with low back pain underwent 20 sessions of lumbar traction with a load of 25% to 30% of their body weight. Total body and lumbar spine BMD was measured using dual-energy X-ray absorptiometry, and bone turnover markers were determined using enzyme-linked immunosorbent assay (ELISA) with serum samples collected before the first traction session and 72 hours after the last traction session.

Results: After traction, decreased BMD and T-scores, a decreased mean vertebra width, and an increased mean height of L1-L4 segments were observed. The concentration of cross-linked C-telopeptide of type I collagen (CTXI) increased, while the concentration of receptor activator for nuclear factor κ B ligand (RANKL) decreased significantly after four weeks of traction. Sclerostin and procollagen 1 N-terminal propeptide (P1NP) concentrations remained unchanged.

Conclusion: Our study is the first to show the influence of traction forces on BMD and markers of bone metabolism. Future research with a longer follow-up period after traction is needed to better explore the direction of change.