Tuesday, January 29, 2008

Spinal Decompression using the DRX 9000 and the Cox technic

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I was recently contacted and asked about the safety of the DRX 9000 spinal decompression machine. In my NYC spinal decompression practice I carefully screen patients for contra-indications and if they are not a candidate for the procedure I do not put them on the machine. In addition to spinal decompression using the DRX 9000 I also combine use of the Cox technic. This technic has been proven to open the IVF or intervertebral foreamen by 28%.
Call (212)645-8151 for spinal decompression in NYC or visit www.drshoshany.com
This past weekend I attended a post graduate seminar on the Cox technic.
I recently added the seventh generation Cox table to my practice.
I wanted to add some information on my blog about what I learned and a description of why I think this techic will improve patient outcomes.
Cox® Technic (aka flexion-distraction or F/D) relieves back and leg pain and neck and arm pain. Disc herniation and/or stenosis may be the cause of pain. Or simple arthritis or a back sprain may be the culprit.

Cox® Technic is a gentle, non-surgical, chiropractic spinal manipulation adjustment procedure.

95% of back pain and neck pain patients DO NOT require surgery.

Cox® Technic is a safe alternative to back surgery. It is also appropriate for failed back surgery patients who still suffer after surgery.

Cox® Technic is a well-researched (with research studies completed and underway), well-referenced (with over 90+ articles in medical and chiropractic journals) chiropractic spinal adjusting manipulation

Cox® Technic drops intradiscal pressures to -192 mmHg and increases the foraminal area by 28%.

Cox® Technic stops pain, realigns the spine and restores ranges of motion inherent to the spine while reducing low back pain, especially in radiculopathy (extremity pain--leg pain or arm pain) patients, better than active exercise therapy.

Innovated by James M. Cox, DC, DACBR, in the 1960's, Cox® Technic is a marriage of osteopathic and chiropractic manipulation principles. It is an accepted and widely used form of spinal manipulation.

THE RESEARCH SAYS...

The Biomechanics Study

Federally Funded Research has thus far proven the following about Cox® Flexion Distraction:


Reduces intradiscal pressures (on nerve roots to relieve pain)

Increases intradiscal height

Increases foraminal size up to 28% (more room for nerve roots and spinal cord)



CLINICAL APPLICATION IS...

The following is presented as a general overview of the treatment.

Cox® Technic is DOCTOR-APPLIED, DOCTOR-CONTROLLED, HANDS-ON, SPECIFIC CONTACT, PATIENT-FOCUSED care. During a treatment on this instrument, the patient lies prone while the treating physician concentrates on one vertebral motion segment at a time. The goal is to reduce stenotic effects by dropping intradiscal pressure to allow disc reduction, increasing the size of the intervertebral foramen, and lowering pressure on the dorsal root ganglion and the exiting nerve roots. While concentrating on the low back, the doctor may use the instrument's caudal (the part the legs lie on) section to allow lateral and circular motion which returns normal motion to the spine with reduced pain. The cervical spine can be treated similarly using a specially designed table.

The Lumbar Spine Adjustment

After undergoing a thorough examination which leads the doctor to a diagnosis of the back condition to be treated, the patient lies on a table that is built to traction the spine and also to produce motions that are normal for the spine. To attain these motions, the table goes "up and down" (flexion and extension), goes "side to side" (lateral flexion), or moves in a circular motion (circumduction). All movements are slow.

The doctor will hold a spinous process (the back part of the vertebra that feels like a "bump" on your spine) to isolate a single segment for treatment. The distraction manipulation is applied manually by the doctor to the patient's low back at the levels of the spine to be treated or that are painful. Tolerance testing is performed prior to the application of distraction manipulation to be sure it causes no pain to the patient. This technic is designed to help patients with low back pain and leg pain.

The Cervical Spine Adjustment

The patient will lie prone (face down) on the table whose headpiece moves in motions that are normal for the cervical spine (Flexion, Extension, Rotation, Lateral flexion, and Circumduction). This headpiece also allows traction to be applied to the cervical or thoracic spines alone or while these motions are being administered. The doctor will hold the appropriate spinous process (back of the vertebra) of the cervical spine to isolate the level of pain or the level of vertebra to be adjusted.



This recent study was posted on the DRX 9000 site.

ORIGINAL ARTICLE
Treatment of 94 Outpatients With Chronic Discogenic Low Back Pain with the DRX9000:

A Retrospective Chart Review

Alex Macario, MD, MBA**Departments of Anesthesia and Health Research & Policy, Stanford University School of Medicine, Stanford, California; Alex Macario MD, MBA, Professor of Anesthesia and Health Research & Policy, Department of Anesthesia H3580, Stanford University School of Medicine, Stanford, CA 94305-5640, U.S.A. Tel: +1 650 498 6810; E-mail: amaca@stanford.edu. ; Charlotte Richmond, PhD††Biomedical Research & Education Foundation, LLC, Miami Beach, Florida; ; Martin Auster, MD, MBA‡‡Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, ; Joseph V. Pergolizzi, MD§§Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.*Departments of Anesthesia and Health Research & Policy, Stanford University School of Medicine, Stanford, California; †Biomedical Research & Education Foundation, LLC, Miami Beach, Florida; ‡Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, §Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Alex Macario MD, MBA, Professor of Anesthesia and Health Research & Policy, Department of Anesthesia H3580, Stanford University School of Medicine, Stanford, CA 94305-5640, U.S.A. Tel: +1 650 498 6810; E-mail: amaca@stanford.edu.
Reprints will not be available from authors.

■ Abstract

Background: This study's goal was a retrospective chart audit of 100 outpatients with discogenic low back pain (LBP) lasting more than 12 weeks treated with a 2-month course of motorized spinal decompression via the DRX9000 (Axiom Worldwide, Tampa, FL, U.S.A.).

Methods: Patients at a convenience sample of four clinics received 30-minute DRX9000 sessions daily for the first 2 weeks tapering to 1 session/week. Treatment protocol included lumbar stretching, myofascial release, or heat prior to treatment, with ice and/or muscle stimulation afterwards. Primary outcome was verbal numerical pain intensity rating (NRS) 0 to 10 before and after the 8-week treatment.

Results: Of the 100 initial subjects, three withdrew their protected health information, and three were excluded because their LBP duration was less than 12 weeks. The remaining 94 subjects (63% female, 95% white, age = 55 (SD 16) year, 52% employed, 41% retired, LBP median duration of 260 weeks) had diagnoses of herniated disc (73% of patients), degenerative disc disease (68%), or both (27%). Mean NRS equaled 6.05 (SD 2.3) at presentation and decreased significantly to 0.89 (SD 1.15) at end of 8-week treatment (P < 0.0001). Analgesic use also appeared to decrease (charts with data = 20) and Activities of Daily Living improved (charts with data = 38). Follow-up (mean 31 weeks) on 29/94 patients reported mean 83% LBP improvement, NRS of 1.7 (SD 1.15), and satisfaction of 8.55/10 (median 9).

Conclusions: This retrospective chart audit provides preliminary data that chronic LBP may improve with DRX9000 spinal decompression. Randomized double-blind trials are needed to measure the efficacy of such systems. ■

Users who read this article also read:
Intervertebral Disc: Anatomy-Physiology-Pathophysiology-Treatment
P. Prithvi Raj, MD, FIPP, ABIPP
Pain Practice, Volume 8, Issue 1, Page 18-44, Mar 2008, doi: 10.1111/j.1533-2500.2007.00171.x
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Intra-articular Application of Pulsed Radiofrequency for Arthrogenic Pain—Report of Six Cases
Menno E. Sluijter, MD, PhD, FIPP; Alexandre Teixeira, MD, FIPP; Vicente Serra, MD; Susan Balogh, MD; Pietro Schianchi, MD, FIPP
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The Prevalence of Facet Joint-Related Chronic Neck Pain in Postsurgical and Nonpostsurgical Patients: A Comparative Evaluation
Laxmaiah Manchikanti, MD; Kavita N. Manchikanti, BA; Vidyasagar Pampati, MSc; Doris E. Brandon, CST; James Giordano, PhD
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Late Whiplash Syndrome: A Clinical Science Approach to Evidence-Based Diagnosis and Management
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Pain Practice, Volume 8, Issue 1, Page 65-89, Mar 2008, doi: 10.1111/j.1533-2500.2007.00168.x
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A Review of the Epidemiology of Painful Diabetic Peripheral Neuropathy, Postherpetic Neuralgia, and Less Commonly Studied Neuropathic Pain Conditions
Alesia Sadosky, PhD; Anne M. McDermott, ScD; Nancy A. Brandenburg, PhD; Marcie Strauss, MPH
Pain Practice, Volume 8, Issue 1, Page 45-56, Mar 2008, doi: 10.1111/j.1533-2500.2007.00164.x
Abstract| References| Full Text HTML| Full Text PDF (114 KB)
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So in conclusion I am confident in my ability to provide patients that have herniated discs, failed back surgery and chronic low back pain a effective means to end their pain and return them to a pain free lifestyle.

Monday, January 21, 2008

Sciatica? DRX9000 Lumbar Spinal Decompression May Be The Answer


Sciatica? DRX9000 Lumbar Spinal Decompression May Be The Answer.
Sciatica treatment in NYC call (212) 645-8151 or visit www.drshoshany.com
The sciatic nerve is the largest nerve in the body. The nerve roots that exit the lumbar spine to form the sciatic nerve are very sensitive. Even the weight of a pencil erasure can irritate them and cause pain that travels down into the buttocks or leg.

In fact...sciatica is pain in the buttocks or leg (radicular pain) from irritation of the sciatic nerve.

So, how does the sciatic nerve become irritated?

Well, this can happen several different ways, here are most of them:

1. A Herniated Lumbar Disc (most common cause of sciatica).

2. Spinal Stenosis or Foraminal Stenosis.

3. Vertebral Subluxation.

4. Degenerative Disc Disease (DDD).

5. Piriformis Syndrome.

6. Sacroiliac Joint Dysfunction.

7. Spondylolisthesis.

8. Trauma (auto accident, skiing injury, sports, etc)

There are a few other causes...but this list covers most of them. The big question here is what can be done to get rid of the symptoms? In my NYC Chiropractic practice I utulize the DRX 9000 along with Cox flexion distaction and Cold laser therapy

Friday, January 11, 2008

DRX 9000 Manhattan New York Chiropractor, DRX 9000 Manhattan

Call 212 645-8151 for DRX 9000 treatment in Manhattan.
I recently purchased the Cox flexion distraction with long axis traction to complement my spinal disc decompression protocol.
This table will allow me to get even better results with patients that medial disc herniations in the lower lumbar spine.
If you suffer from Failed Back Surgical Syndromes

Disc Herniation / Ruptured Disc / Bulging Disc / Herniated Disc

Sciatica / Leg Pain

Stenosis

Arm Pain

Neck Pain

Failed course of Steroid Injections

Chemical Radiculitis

Spondylolisthesis

Synovial Cyst

Headache

"Hip Pain" due to sciatic nerve irritation

Transitional segment
The combination of the DRX 9000 spinal decompression table and the Cox technique is tremendously effective in treating these conditions without surgery.
I am the only Chiropractor in New York city that combines these two amazing tools to give the most complete Non-surgical approach to treat these difficult conditions.

Thursday, January 03, 2008

herniated disc DRX 9000 treatment

Call (212) 645-8151 for DRX 9000 treatment in NYC.
First off Happy New Year to everyone!
I have had doctors from across the world contacting me about my spinal decompression protocols.The one thing I tell them is Be picky with who you accept.
I turn down more patients than I accept. This is usually due to the fact that they are not the ideal candidate.
To get great results with spinal decompression I believe the equipment you use is crucial.
I do not work for any table manufactures but I have used many tables and I prefer the DRX 9000 table. It is the workhorse of the industry and is in my opinion the most comfortable to the patient and the most sturdy and reliable table. I have to agree that some of the marketing that went along with was questionable but the table does provide excellent results when combined with proper PT and rehab it is a tool not the end all.
I highly urge any doctor looking to buy a table to test drive different table and decide not only on price.
I know to many "cheap chiropractors" to but DTS tables only to sell them 2 months later because they do not get the results they expected and patients get upset about results.
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