Contents of New York Spinal Decompression
Spinal Decompression NYC
(212) 645-8151

1. Why Spinal Disc Decompression Works 9. Methods
2. What is a Disc? What does a Disc do? 10. Patient Groups
3. Bulging Disc 11. Results
4. Leg Pain or Sciatica 12. FAQ
5. Pain in legs like Sciatica 13. Summary
6. Decompression technology 14. References
7. Spinal Decompression 15. Spinal Decompression Research
8. Introduction: Advances in Biotechnology 16. What is Spinal Decompression Thearapy?



Manhattan Spinal Decompression Specialist

Spinal Decompression is a non-surgical and drug-free answer for disc related syndromes of the lumbar or cervical spine. Many people across the country have found relief from the pain associated with herniated discs, bulging discs, facet syndrome, degenerative joint disease, pinched nerves, and other spinal afflictions.Spinal Disc Decompression uses computer-aided technology to apply gentle, non-surgical decompression to your spine, increasing circulation into the spinal discs and joints, thus helping to relieve the symptoms that cause pain and dysfunction.We use the exclusive DRX 9000 machine in our Manhattan office. The best Non Surgical Spinal Decompression table on the Market.


Why Spinal Disc Decompression Works:

This FDA cleared technology relieves pain by enlarging the space between the discs. The negative pressure of decompression releases pressure that builds on to the disc and nerves, allowing the herniated and bulging disc to eventually go back into normal position. Decompression is the only treatment that is truly most effective for severe cases of herniation, degeneration, arthritis, stenosis and pressure on the nerve root. According to a clinical study performed by the Orthopedic Technological Review in 2004, said that 86% of all cases experienced spinal pain relief with disc decompression.

What is a Disc? What does a Disc do?

The disc is a soft cartilaginous material that seperates the spinal vertabrae. We have Discs starting at the the third cervical all the way down to the lowest Lumbar vertabrae L 5. The Discs middle is called the nucleus and and outer layer called the annulus.These discs act as shock absorbers and these disc after we are done growing usually arounf 19 years old become avascualr (does not receive a good blood supply). One of the reasons that our discs give us so many problems is that it does not heal well without a good blood supply. When we break a bone it heals quickly and actually stronger than before! Our discs are avascular so if a disc is injured it continues to degenerate and does not heal properly. One of the amazing benefits of decompression is that it heightens the disc space, and is seen to return it to normal size and function.

The Decompression therapy also causes the disc to heal because the treatment stimulates the cartildge to regenerate and act it cannot do on its own without the decompression treatment.Spinal Decompression also causes the nutrient rich blood to fill the disc space which fosters the healing response.

Dr. Steven Shoshany a New York Chiropractor will take a complete initial history, perform a physical evaluation, review all data including MRI´s to prequalify the patient to ensure the decompression procedures will benefit the patient.

Dr. Shoshany has been expertly trained in the delivery of spinal decompression and has dedicated a large portion of his practice to the relief of severe and chronic low back pain and cervical pain and assisting the patient to return to a normal, pain free life.


Bulging Disc

To really understand what a Bulging disc I will discuss the classifications to describe the disc lesions because there is a plethora of terms commonly encountered like Disc Prolapse, Slipped Disc,ruptured disc,disk herniation.

The term Disc Herniation implies that a rupture or a tear of the annular fibers occurs allowing the migration of nucleur material beyond the verterbral margin. The nuclear material may protrude out and cause a distention of the outer annulus fibrosis or rupture through the annulus and extrude behind the posterior ligament.

Four classifications exist to describe disc lesions

1. Annular bulge

2. Protrusion (Herniation)

3. Extrusion

4. Free Disc Fragment (Sequestration).

The annular bulge or Disc bulge is a small disc herniation that does not directly contact the nerve root and left untreated can easily progress to a larger degree of nuclear protrusion because of the loss of the annular fibers to contain the nucleus. Degeneration will predispose annular fibers to failure following trauma.

Disc Protrusion (Herniation) A Disc herniation represents a rupture of nuclear material through a defect in annulus, producing a focal extension of the disc or a broad based extension of the disc margin.Intervertebral disc herniations result in some degree from central canal or foraminal occlusion.

Disk Extrusion applies when a portion of the nucleus pulposus fibrocartilage and end plate cartilage have migrated through comprised outer annular fibers. Disc extrusions may compress the root, cord or both and can cause myeloradiculopathy( shooting pain).

Free disc Fragment (Sequestered Disc) refers to the extra-annular seperation and migration of a piece of nuclear material. Cauda Equina syndrome are common with intradural migration. This is when you lose control of bowel and bladder function. This is a emergency situatiion and usually requires surgery to correct the problem.

The most common area is the Lower Lumbar vertabre L5. The pressure causes the jelly material inside the disc to "bulge" or "slip" out of place .The bulge itself puts pressure on the nerves( usually the spinal nerve).The Spinal nerve is very sensitive even a small amount of pressure causes the nerve to dysfunction. The most common cervical disc to herniate is also the fifth and can cause cervicobrachial syndrome or symptoms like carpal tunnel sydrome or weakness in the arms or a burning sensation in the arms.

Disc Dessication is when the annullar fibers degenerate due to dehydration, One preventative step is to drink as much water as can if you feel that you have or are developing a Disc Herniation.


Leg Pain or Sciatica

Pain in legs like Sciaitica

The Sciatic nerve is the largest nerve in the body and it is a common problem with people and when a disc herniates it can causes Sciaitica which can feel like a sharp shooting pain down the look into the buttocks or even into the toes. In extreme examples it can cause permanent nubmness and loss of muscle strength.

Decompression technology

NASA does not endorse any equipment or table nor do they claim that this was their discovery.

. The FDA cleared several tables to be caled Spinal Disc decompression and they all do basically the same thing some have fancier options. Some of these tables have names like the spine med, the lordex machine, ABS, Extentrac, 3D active trac. In my practice I use the DRX 9000 unit because I believes it utulizes the latest technological advances is the most comfortable.

I also like to point out that the DRX 900 is the only system with a FDA 510K which is a clearance to be called true spinal decompression, its the only system with a documented 86% success rate it offers a Closed loop feedback system ensuring precise treatment ,and it targets the specific disc level based on video fluroscopy studies.

Spinal Decompression causes the Disc material to get sucked back into the joint space and the outer layer is made stronger by stimulating the cartilidge to regenerate to prevent rei-njury.

Dr. Steven Shoshany is so confident that Spinal Decompression will heal your disc problems that he is offering a satisfaction guarantee,

No other Chiropractor in New York City will offer this! There are doctors office that offer similar procedures such as the DRX 9000. You will find that I have invested time and money in really understanding this amazing technology! If you live in the New York City Metro area please do your research and if you have any questions please feel free to email the doctor and he will answer all questions right away and give you a straight answer. drstevenshoshany@yahoo.com

Spinal Decompression

By Thomas A. Gionis, MD, JD, MBA, MHA, FICS, FRCS, and Eric Groteke, DC, CCIC

The outcome of a clinical study evaluating the effect of nonsurgical intervention on symptoms of spine patients with herniated and degenerative disc disease is presented.

This clinical outcomes study was performed to evaluate the effect of spinal decompression on symptoms and physical findings of patients with herniated and degenerative disc disease. Results showed that 86% of the 219 patients who completed the therapy reported immediate resolution of symptoms, while 84% remained pain-free 90 days post-treatment. Physical examination findings showed improvement in 92% of the 219 patients, and remained intact in 89% of these patients 90 days after treatment. This study shows that disc disease, the most common cause of back pain, which costs the American health care system more than $50 billion annually can be cost-effectively treated using spinal decompression. The cost for successful non-surgical therapy is less than a tenth of that for surgery. These results show that biotechnological advances of spinal decompression reveal promising results for the future of effective management of patients with disc herniation and degenerative disc diseases. Long-term outcome studies are needed to determine if non-surgical treatment prevents later surgery, or merely delays it.

Introduction: Advances in Biotechnology

With the recent advances in biotechnology, spinal decompression has evolved into a cost-effective nonsurgical treatment for herniated and degenerative spinal disc disease, one of the major causes of back pain. This nonsurgical treatment for herniated and degenerative spinal disc disease works on the affected spinal segment by significantly reducing intradiscal pressures.1 Chronic low back pain disability is the most expensive benign condition that is medically treated in industrial countries. It is also the number one cause of disability in persons under age 45. After 45, it is the third leading cause of disability.2 Disc disease costs the health care system more than $50 billion a year.

The intervertebral disc is made up of sheets of fibers that form a fibrocartilaginous structure, which encapsulates the inner mucopolysaccharide gel nucleus. The outer wall and gel act hydrodynamically. The intrinsic pressure of the fluid within the semirigid enclosed outer wall allows hydrodynamic activity, making the intervertebral disc a mechanical structure.3 As a person utilizes various normal ranges of motion, spinal discs deform as a result of pressure changes within the disc.4 The disc deforms, causing nuclear migration and elongation of annular fibers. Osteophytes develop along the junction of vertebral bodies and discs, causing a disease known as spondylosis. This disc narrows from the alteration of the nucleus pulposus, which changes from a gelatinous consistency to a more fibrous nature as the aging process continues. The disc space thins with sclerosis of the cartilaginous end plates and new bone formation around the periphery of the contiguous vertebral surfaces. The altered mechanics place stress on the posterior diarthrodial joints, causing them to lose their normal nuclear fulcrum for movement. With the loss of disc space, the plane of articulation of the facet surface is no longer congruous. This stress results in degenerative arthritis of the articular surfaces.5

This is especially important in occupational repetitive injuries, which make up a majority of work-related injuries. When disc degeneration occurs, the layers of the annulus can separate in places and form circumferential tears. Several of these circumferential tears may unite and result in a radial tear where the material may herniate to produce disc herniation or prolapse. Even though a disc herniation may not occur, the annulus produces weakening, circumferential bulging, and loss of intervertebral disc height. As a result, discograms at this stage usually reveal reduced interdiscal pressure.

The early changes that have been identified in the nucleus pulposus and annulus fibrosis are probably biomechanical and relate to aging. Any additional trauma on these changes can speed up the process of degeneration. When there is a discogenic injury, physical displacement occurs, as well as tissue edema and muscle spasm, which increase the intradiscal pressures and restrict fluid migration.6 Additionally, compression injuries causing an endplate fracture can predispose the disc to degeneration in the future.

The alteration of normal kinetics is the most prevalent cause of lower back pain and disc disruption and thus it is vital to maintain homeostasis in and around the spinal disc; Yong-Hing and Kirkaldy-Willis7 have correlated this degeneration to clinical symptoms. The three clinical stages of spinal degeneration include:

  1. Stage of Dysfunction. There is little pathology and symptoms are subtle or absent. The diagnosis of Lumbalgia and rotatory strain are commonly used.

  2. Stage of Instability. Abnormal movement of the motion segment of instability exists and the patient complains of moderate symptoms with objective findings. Conservative care is used and sometimes surgery is indicated.

  3. Stage of Stabilization. The third phase where there are severe degenerative changes of the disc and facets reduce motion with likely stenosis.

Spinal decompression has been shown to decompress the disc space, and in the clinical picture of low back pain is distinguishable from conventional spinal traction.8,9 According to the literature, traditional traction has proven to be less effective and biomechanically inadequate to produce optimal therapeutic results.8-11 In fact, one study by Mangion et al concluded that any benefit derived from continuous traction devices was due to enforced immobilization rather than actual traction.10 In another study, Weber compared patients treated with traction to a control group that had simulated traction and demonstrated no significant differences.11 Research confirms that traditional traction does not produce spinal decompression. Instead, decompression, that is, unloading due to distraction and positioning of the intervertebral discs and facet joints of the lumbar spine, has been proven an effective treatment for herniated and degenerative disc disease, by producing and sustaining negative intradiscal pressure in the disc space. In agreement with Nachemon´s findings and Yong-Hing and Kirkaldy-Willis,1 spinal decompression treatment for low back pain intervenes in the natural history of spinal degeneration.7,12 Matthews13 used epidurography to study patients thought to have lumbar disc protrusion. With applied forces of 120 pounds x 20 minutes, he was able to demonstrate that the contrast material was drawn into the disc spaces by osmotic changes. Goldfish14 speculates that the degenerated disc may benefit by lowering intradiscal pressure, affecting the nutritional state of the nucleus pulposus. Ramos and Martin8 showed by precisely directed distraction forces, intradiscal pressure could dramatically drop into a negative range. A study by Onel et al15 reported the positive effects of distraction on the disc with contour changes by computed tomography imaging. High intradiscal pressures associated with both herniated and degenerated discs interfere with the restoration of homeostasis and repair of injured tissue.

Biotechnological advances have fostered the design of Food and Drug Administration-approved ergonomic devices that decompress the intervertebral discs. The biomechanics of these decompression/reduction machines work by decompression at the specific disc level that is diagnosed from finding on a comprehensive physical examination and the appropriate diagnostic imaging studies. The angle of decompression to the affected level causes a negative pressure intradiscally that creates an osmotic pressure gradient for nutrients, water, and blood to flow into the degenerated and/or herniated disc thereby allowing the phases of healing to take place.

This clinical outcomes study, which was performed to evaluate the effect of spinal decompression on symptoms of patients with herniated and degenerative disc disease, showed that 86% of the 219 patients who completed therapy reported immediate resolution of symptoms, and 84% of those remained pain-free 90 days post-treatment. Physical examination findings revealed improvement in 92% of the 219 patients who completed the therapy.

Methods

The study group included 229 people, randomly chosen from 500 patients who had symptoms associated with herniated and degenerative disc disease that had been ongoing for at least 4 weeks. Inclusion criteria included pain due to herniated and bulging lumbar discs that is more than 4 weeks old, or persistent pain from degenerated discs not responding to 4 weeks of conservative therapy. All patients had to be available for 4 weeks of treatment protocol, be at least 18 years of age, and have an MRI within 6 months. Those patients who had previous back surgery were excluded. Of note, 73 of the patients had experienced one to three epidural injections prior to this episode of back pain and 22 of those patients had epidurals for their current condition. Measurements were taken before the treatments began and again at week two, four, six, and 90 days post treatment. At each testing point a questionnaire and physical examination were performed without prior documentation present in order to avoid bias. Testing included the Oswetry questionnaire, which was utilized to quantify information related to measurement of symptoms and functional status. Ten categories of questions about everyday activities were asked prior to the first session and again after treatment and 30 days following the last treatment.

Testing also consisted of a modified physical examination, including evaluation of reflexes (normal, sluggish, or absent), gait evaluation, the presence of kyphosis, and a straight leg raising test (radiating pain into the lower back and leg was categorized when raising the leg over 30 degrees or less is considered positive, but if pain remained isolated in the lower back, it was considered negative). Lumbar range of motion was measured with an ergonometer. Limitations ranging from normal to over 15 degrees in flexion and over 10 degrees in rotation and extension were positive findings. The investigator used pinprick and soft touch to determine the presence of gross sensory deficit in the lower extremities.

Of the 229 patients selected, only 10 patients did not complete the treatment protocol. Reasons for noncompletion included transportation issues, family emergencies, scheduling conflicts, lack of motivation, and transient discomfort. The patient protocol provided for 20 treatments of spinal decompression over a 6-week course of therapy. Each session consisted of a 45-minute treatment on the equipment followed by 15 minutes of ice and interferential frequency therapy to consolidate the lumbar paravertebral muscles. The patient regimen included 2 weeks of daily spinal decompression treatment (5 days per week), followed by three sessions per week for 2 weeks, concluding with two sessions per week for the remaining 2 weeks of therapy.


Table 1. Patient demographic chart.

On the first day of treatment, the applied pressure was measured as one half of the person´s body weight minus 10 pounds, followed on the second day with one half of the persons body weight. The pressure placed for the remainder of the 18 sessions was equivalent to one half of the patient´s body weight plus an additional 10 pounds. The angle of treatment was set according to manufacturer´s protocol after identifying a specific lumbar disc correlated with MRI findings. A session would begin with the patient being fitted with a customized lower and upper harness to fit their specific body frame. The patient would step onto a platform located at the base of the equipment, which simultaneously calculated body weight and determined proper treatment pressure. The patient was then lowered into the supine position, where the investigator would align the split of table with the top of the patient´s iliac crest. A pneumatic air pump was used to automatically increase lordosis of the lumbar spine for patient comfort. The patient´s chest harness was attached and tightened to the table. An automatic shoulder support system tightened and affixed the patient´s upper body. A knee pillow was placed to maintain slight flexion of the knees. With use of the previously calculated treatment pressures, spinal decompression was then applied. After treatment, the patient received 15 minutes of interferential frequency (80 to 120 Hz) therapy and cold packs to consolidate paravertebral muscles.

During the initial 2 weeks of treatment, the patients were instructed to wear lumbar support belts and limit activities, and were placed on light duty at work. In addition, they were prescribed a nonsteroidal, to be taken 1 hour before therapy and at bedtime during the first 2 weeks of treatment. After the second week of treatment, medication was decreased and moderate activity was permitted.

Data was collected from 219 patients treated during this clinical study. Study demographics consisted of 79 female and 140 male patients. The patients treated ranged from 24 to 74 years of age (see Table 1). The average weight of the females was 146 pounds and the average weight of the men was 195 pounds. According to the Oswestry Pain Scale, patients reported their symptoms ranging from no pain (0) to severe pain (5).

Patient Groups

The patients were further subdivided into six groups:

  1. single lateral herniation 67 cases
  2. single central herniation 22 cases
  3. single lateral herniation
    with disc degeneration 32 cases
  4. single central herniation
    with disc degeneration. 24 cases
  5. more than 1 herniation
    with disc degeneration 17 cases
  6. more than 1 herniation
    without disc degeneration 57 cases

Results

According to the self-rated Oswestry Pain Scale, treatment was successful in 86% of the 219 patients included in this study (Table 2, page 39). Treatment success was defined by a reduction in pain to 0 or 1 on the pain scale. The perception of pain was none 0 to occasional 1 without any further need for medication or treatment in 188 patients. These patients reported complete resolution of pain, lumbar range of motion was normalized, and there was recovery of any sensory or motor loss. The remaining 31 patients reported significant pain and disability, despite some improvement in their overall pain and disability score.

Diagnosis MRI
Findings
No. of CaseS Female Patients Male Patients Positive Result No Result % of Success
Single Herniation Lateral 67 26 41 63 4 94
Single Herniation Central 22 11 11 20 2 90
Single Herniation w/ Degeneration 24 5 19 24 0 100
Single Herniation Lateral w/ Degeneration 32 14 18 29 3 91
Multiple Herniations w/o Degeneration 57 21 36 39 18 68
Multiple Herniations w/ Degeneration 17 2 15 13 4 77
TOTAL 219 79 140 188 31 86

Table 2. Results on self-rated Oswestry Pain Scale after treatment.

In this study, only patients diagnosed with herniated and degenerative discs with at least a 4-week onset were eligible. Each patient´s diagnosis was confirmed by MRI findings. All selected patients reported 3 to 5 on the pain scale with radiating neuritis into the lower extremities. By the second week of treatment, 77% of patients had a greater than 50% resolution of low back pain. Subsequent orthopedic examinations demonstrated that an increase in spinal range of motion directly correlated with an improvement in straight leg raises and reflex response. Table 2 shows a summary of the subjective findings obtained during this study by category and total results post treatment. After 90 days, only five patients (2%) were found to have relapsed from the initial treatment program.

Diagnosis MRI Findings Improved Gait Sluggish to Normal Reflexes Improved Sensory Reception Improved Motor Limitation Abnormal to Normal Straight Leg Raise Test Improved Spinal Range of Motion
Single Herniation Lateral 98% 98% 96% 90% 92% 95%
Single Herniation Central 100% 100% 94% 92% 96% 90%
Single Herniation w/ Degeneration 99% 96% 90% 84% 94% 90%
Single Herniation Lateral w/ Degeneration 94% 97% 94% 88% 90% 92%
Multiple Herniations w/o Degeneration 96% 94% 94% 81% 82% 92%
Multiple Herniations w/ Degeneration 92% 94% 88% 82% 80% 82%
AVERAGE IMPROVEMENT 96% 96% 93% 86% 89% 90%

Table 3. Percentage of patients that had improved physical exam findings post treatment.

Ninety-two percent of patients with abnormal physical findings improved post-treatment. Ninety days later only 3% of these patients had abnormal findings. Table 3 summarizes the percentage of patients that showed improvement in physician examination findings testing both motor and sensory system function after treatment. Gait improved in 96% of the individuals who started with an abnormal gait, while 96% of those with sluggish reflexes normalized. Sensory perception improved in 93% of the patients, motor limitation diminished in 86%, 89% had a normal straight leg raise test who initially tested abnormal, and 90% showed improvement in their spinal range of motion.

Frequently Asked Questions

What is the difference between decompression and traction?

Many clinicians specializing in lumbar spine pathology have criticized traditional traction. Traction fails in many cases because it causes muscular stretch receptors to fire, which then cause para-spinal muscles to contract. This muscular response actually causes an increase in intradiscal pressure. On the other hand, genuine decompression is achieved by gradual and calculated increases of distraction forces to spinal structures, utilizing various degrees of distraction forces.

A highly specialized computer must modulate the application of distraction forces in order to achieve the ideal effect. The system uses applies a gentle, curved angle pull which yields far greater treatment results that a less comfortable, sharp angle pull. Distraction must be offset by cycles of partial relaxation.

The system continuously monitors spinal resistance and adjusts distraction forces accordingly. A specific lumbar segment can be targeted for treatment by changing the angle of distraction. This patented technique of decompression may prevent muscle spasm and patient guarding. Constant activity monitoring takes place at a rate of 10,000 times per second, making adjustments not perceived by the eye as many as 20 times per second via its fractional metering and monitoring system.

Genuine decompression also involves the use of a special pelvic harness that supports the lumbar spine during therapy. Negative pressure within the disc is maintained throughout the treatment session. With genuine decompression, the pressure within the disc space can actually be lowered to about -150 mmHg. As a result, the damaged disc will be rehydrated with nutrients and oxygen.

Isn´t decompression just a fancy name for a traction machine?

No. There is a big different between traction, distraction and decompression. Traction has been around for hundreds, if not thousands of years. The problem with traction as it is known today is that it is not always beneficial. In 1998, the Scientific American rated traction to be of little or no value in the examination of efficacious therapies for lower back pain. This finding is consistent with many studies that report traction can often times signal a nociceptive splinting response and put a patient's back muscles in spasm, resisting any attempts to effect a change on the disc proper.

Distraction, a term used to describe a flexion distraction technique, attempts to reposition the spine from the offending lesion. This technique has been shown to be very effective, even though potentially damaging to the person performing the technique and largely dependent on the skill of the technician. Like traction, distraction procedures are limited in the ability to reduce the intradiscal pressure, or produce a negative pressure within the disc imbibing fluid, nutrients and creating an environment for repair.

Decompression therefore is an event - a combination of restraint, angle position and equipment engineering. One can experience traction without decompression, but not decompression without traction. Traction is a machine - Decompression is an event.

What result can I expect?

Many patients with lower back syndromes may experience pain relief as early as the third treatment session. Comparison of pre-treatment MRI´s with post-treatment MRI´s has shown a 50% reduction in the size and extent of herniation. In clinical studies, 86% of patients reported relief of back pain with the our system. Within the past five years, some private practice clinicians have reported success rates as high as 90%.

What time commitments are required by patients?

Each treatment session averages 25 to 30 minutes in duration (research has established that optimum results are achieved with sessions that incorporate 10 to 15 decompression/relaxation cycles). On average, one daily session for 20-30 treatments is necessary for patient self-healing to occur.

Herniated discs generally respond within 20 sessions, while patients with degenerated discs may need ongoing therapy at regulated intervals to remain pain free. Still other patients, due to lifestyle or occupation, may also require maintenance therapy. Patients with posterior facet syndromes may achieve complete remission with 10 or fewer sessions. Research has demonstrated that most patients achieve full remission from pain after the initial treatment regimen.

What is the typical diagnosis?

Since non-specific low back pain and cervical pain generally encompass a myriad of mechanical failures, including muscles, tendons, ligaments, and other soft tissue that encroach or produce pressure on the nerves, the term intervertebral disc syndrome can be used. This diagnosis does not necessarily require (although recommended) an MRI to confirm the presence of a disc involvement

Who can benefit from using Disc Decompression Therapy?

The following would be inclusion criteria for the Decompression Therapy (1) Pain due to herniated and bulging lumbar discs that is more than four weeks old; (2) Recurrent pain from a failed back surgery that is more than six months old; (3) Persistent pain from degenerated discs not responding to four weeks of therapy; (4) Patients available for four weeks of treatment protocol; and (5) Patient at least 18 years of age.

These indications are ideal candidates for enrollment into our program and have the potential of achieving quality outcomes in the treatment of their back pain: (1) Nerve Compression; (2) Lumbar Disorders; (3) Lumbar Strains; (4) Sciatic Neuralgia; (5) Herniated Discs; (6) Injury of the Lumbar Nerve Root; (7) Degenerative Discs; (8) Spinal Arthritis; (9) Low Back Pain w/ or w/o Sciatica; (10) Degenerative Joint Disease; (11) Myofasctois Syndrome; (12) Disuse Atrophy; (13) Lumbar Instability; (14) Acute Low Back Pain; and (15) Post-Surgical Low Back Pain.

Lastly, the system should be utilized with patients with low back pain, with or without radiculopathy who have failed conventional therapy (physiotherapy and chiropractic) and who are considering surgery. Surgery should only be considered following a reasonable trial of Decompression therapy protocols.

What conditions are contraindicated?

Patients with the following problems or symptoms are usually excluded from using the Spinal Decompresion therapy: Pregnancy, Prior lumbar surgical fusion, Metastatic cancer, Severe osteoporosis, Compression fracture of lumbar spine below L-1, Pars defect, Aortic aneurysm, Pelvic or abdominal cancer, Disc space infections, Severe peripheral neuropathy, Hemiplegia, paraplegia, or cognitive dysfunction, Cauda Equina syndrome, Tumors, osteod osteoma, multiple myeloma, osteosarcoma, Infection, osteomyelitis, meningitis, virus, and HNP (sequestered/free floating fragment).

How long is each session and what is the treatment protocol?

Each session on the Decompression equipment is approximately 25-40 minutes long (45 minute sessions include set-up and take-off), accompanied by 15 minutes of stimulation, heat packs and manipulation. The patient comes for 20-30 visits over a 4-6 week period. The doctor will provide a complete copy of the Spinal decompression treatment protocol upon request.

How long before a patient experiences change?

Often times a patient experiences some relief within the first few (3-7) treatments. Usually by the 12th to 15th treatment all patients have reported some remission of symptoms. Patients not showing significant improvement by the 15th to 18th session may be referred for further diagnostic evaluation.

Does decompression therapy work for everyone?

Eighty-to-ninety percent of patients who have been properly selected and comply with the Spinal Disc Decompression protocol will have good-to-excellent outcomes. Patient´s conditions that do not respond quickly to the therapy are often unable to be helped by anything quickly. Patients vary in age, sex and body morphology and may require counseling in weight loss, nutrition and other lifestyle changes.

Disc herniation signs and symptoms

If you sneeze, Cough or bear down and it hurts this is usually an indication that the disc is involved. Patients can have Back pain with or without leg pain and leg pain and weakness without back pain.

Why doesn't insurance pay for Spinal Decompression?

As with most new procedures like Lasik eye surgery or gastric bypass the insurance companies take there time in reimbursing for these procedures. We all know that Lasik eye surgery works but most insurance still do not pay for it. Some carriers are starting to pay for Spinal Decompression. Some workers compensation authorize and pay for spinal decompression therapy and certain major medical policies like Cigna are slowly starting to recognize the value. I have been able to recently get paid my most major meds as of 11/01/07!

What is the Z-grav table? Is it better than the DRX 9000?

The Z- grav table is a table that is made by North American Medical for Spinal-Aid doctors. There is nothing better about the Z-grav table than the DRX 9000. The DRX 9000 holds more patents and is the most comfortable table on the market. The Z-grav has yet to gain FDA approval since the last time I checked. It is a good table but not superior the DRX 9000.

What about the DTS table?

Chattanooga DTS system or a.k.a as the DTS is my opinion is an inferior table compared to the DRX 9000 or the Spine-med table. I have been utulizing spinal decompression in my practce for 4 plus years longer than most chiropractors in Manhattan. Several new Chiropractors have added this table to their practice and even are offering the first five visits free. I believe that you get what you pay for and I have made a major investment in my practice and my patients health. Why settle for inexpensive equipment? The Chattanooga table is about $ 8,000 K and the DRX is about $95 K, What table do you want to be treated on? If that is the only table you have access to then it can't hurt you, but if you want top of the line spinal decompression and want to treated on the best then go with the table that has set the benchmark, the DRX 9000. I do not offer free treatments but I do offer a free consultation. If you have an MRI report or better yet the actual film I will review them and give you a second opinion. Call (212) 645-8151 begin_of_the_skype_highlighting (212) 645-8151 end_of_the_skype_highlighting to speak to me directly.

Do I need a MRI?

Although a recent MRI has become the gold standard to document presence of a herniated disc ,their are abnormal types of movements that can be shown on radiographs while the patient is holding their spine in full extension and flexion. The two radiologic change that are indicative of instability, vacum sign(Knuttson's phemenom of gas in the disc) and the "traction spur" also known as the Macnab spur. So if a recent MRI is not available the use of a radiograph can point to a lumbar instability. I recently purchased a high speed low dose digital system for use in my practice.

What is KDM

(Kinetic Decompression Mobiliaztion) and how is it different from traditional spinal decompression?

www.drshoshany.com
KDM(Kinetic Decompression Mobilization)NYC
This is a relatively new form of spinal decompression which unloads in various range of motions, there has not been any studies to prove that this form of decompression is any better then traditional long y axis decompression.I honestly have looked into this new table and see promise,but I have yet to find one clinical study or documentation that proves that this type of spinal decompression is any better that straight linear decompression.
Linear decompression which is done on the DRX 9000 or similar tables have been studied and researched and documented to be both safe and effective.
If you suffer with a herniated disc or have chronic neck and Low back pain consider spinal decompression before surgery.
www.drshoshany.com

To have an effective spinal decompression program several components must be addressed like 1) Nutrition- A combination of nutrients and herbs to help heal damaged tissues 2) effective rehab program which includes training on the Spine Force and Power Plate and the MedX medical grade strengthening equipment 3) custom bracing to support muscles and disc-back bracing 4) Heat prior to and ice post decompression along with a form of high volt stimulation 5) Patients must learn how not to re injure themselves- I conduct a weekly back care class that educates patients on proper lifting and body bio mechanics
6) one commonly overlooked area is the feet, I conduct a computerized gait analysis to assess the biomechanics of a patients gait and build a custom made orthotic to correct the gait(the way patients walk) 7)Cox Flexion distraction- which is the only technique that (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.
8) Effective pain non-narcotic pain relieving techniques like Cold laser therapy,ultrasound and the Graston technique
9) On-site medical care, some patients will have pain that may need medical management knowing that this is onsite and available to our patients is comforting.
10) Onsite Diagnostics using state of the art Digital radiographs that will determine the exact level of involvement and the ability to so patients when the area improves is vital to care plan. A Board certified radiologist will re-read MRI's to determine the level of disc herniation.

So to wrap this discussion up, I believe that I have the most effective spinal decompression protocol in Manhattan but don't take my word please visits my website at www.drshoshany.com and read patient testimonials

Patient Care

While patient undergo Spinal Decompression treatment I recommend the following nutrional support 1) 1500 mg. of a high quality Omega fatty acid I like Nordaic naturals 2) Calcium magnissium 1:1 ration

Drink Water every hour you are awake and if you smoke quit ,Smoking causes the disc to degenerate rapidlly . In order for the disc to function properly it must be well hydrated. Most people are chronically dehydrated, I suggest that patients undergoing spinal decompression drink 1 cup of water for every hour they are awake. The body is approximately 73% water. People who are dehydrated and have musculoskeletal problems are at about 55% water. The spinal disc nucleus is 88% water. Degenerative discs are dehydrated and have abnormal function. I recommend patients drink an ounce of water per pound of body weight per day with consumption of 1-2 ounces of mineral salt like realsalt mixed in with the water.

Herniated Discs

What are herniated discs?

The 24 vertebrae of your spine are separated from one another by pads of cartilage called discs. These discs have a fairly tough outer layer with a soft interior to cushion against the shocks and strains experienced as you move and put various stresses on your spine. The discs are subject to injury, disease, and degeneration with use over time. Certain activities and types of work increase the risk of discs being damaged or deteriorating. When the soft interior material of a disc pushes out through a tear or weakening in the outer covering, the disc is said to be herniated.

Herniated discs are also called protruding, bulging, and ruptured, prolapsed, slipped, or degenerated discs. There are fine distinctions between these terms, but all really refer to a disc that is no longer in its normal condition and/or position. Herniated discs cause pain by impinging on (intruding upon, irritating, and pinching) and even injuring nerves in the spinal column.

What are some of the typical symptoms of herniated discs ?

Most disc herniation takes place in the lower back (lumbar spine). The second most common site of herniation is the neck (cervical spine). A herniated lumbar disc may send pain shooting down through your buttock and thigh into the back of your leg (sciatica). Cervical disc herniation may cause pain in the shoulder, arm, and hand. Herniated discs can cause muscle weakness, make it hard to get up when you've been sitting or lying down, cause pain when you strain to do something, even when you cough or sneeze. They sometimes produce pain in the lower right side of the abdomen. Herniated discs may also affect nerves to the bladder and bowel, causing incontinence. This symptom signals the need for immediate, emergency attention.

How does low back injury occur ?

Injury occurs when external load exceeds the failure tolerance or strength of the tissue. In particular, low back injury has been shown to result from repetitive motion at end-range. According to McGill, it is usually a result of "a history of excessive loading which gradually but progressively reduces the tissue failure tolerance" (McGill 1998).

Disc injury has been shown to be related to three factors: first, full end-range flexion in younger spines (due to higher water content) (Adams, Hutton 1982; Adams, Hutton 1985; Adams, Muir 1976); second: repetitive end-range flexion loading motion in excess of 20-30,000 cycles (King 1993; Gordon et al., 1991); and third, epidemiological association between disc herniation and sedentary sitting occupations (Videman et al., 1990).

Certain times of the day are the most vulnerable for the back. Disc bending stresses are increased by 300% and ligaments by 80% in the early morning (Adams MA et al., 1987). McGill has reported that after just three minutes of full flexion, subjects lost half of their stiffness (McGill, 19 Injury Prevention Advice

Tissue conditioning must occur as exposure to load increases. If rest time is inadequate, training is absent, or forces are excessive, then injury will eventually result. Too little or infrequent exposure to external load and conditioning never raises the tissue failure tolerance. In other words too much, frequent or prolonged exposure, and adaptation can't keep pace.

Knowledge of when an injury is most likely to occur can also influence what we do. Early morning or after prolonged sitting are particularly vulnerable times. Reilly et al. (Reilly et al., 1984) showed that 54% of the loss of disc height (water content) occurs in the first 30 minutes after arising. Disc bending stresses are increased significantly in the morning (Adams, et al. 1987). After even a brief period of sitting or stooping, end-range protective joint stiffness is compromised (McGill, 1999). Even after 30 minutes of rest, residual joint laxity persisted! Therefore, avoidance of high-risk activities early in the morning or after sitting or stooping in full flexion is crucial to injury or rein jury prevention.

Suggestions to teach workers to lift with their knees, not their backs, are overly simplistic. Most workers have learned various techniques to avoid injury which are inconsistent with this advice. Better advice is consistent with the following principles: Avoid end-range motion. Rotate jobs to vary loads. Allow frequent rest breaks. Keep loads close to the spine (McGill, Norman, 1993)

Patients begin with a simple warm-up involving the cat/camel exercise on all fours. This should be performed first thing in the morning and then prior to endurance training exercises. Between 8-10 repetitions are all that are needed. Think of the cat/camel as a limbering, rather than stretching, movement.

After performing the cat/camel, the patient is ready for simple exercises to improve the endurance of the abdominal and back muscles. Incorporated into each exercises should be a motor control component teaching "neutral spine" kinesthetic awareness. The main emphasis of rehabilitative exercise is to train "inner range" endurance. This requires kinesthetic awareness of "neutral spine" postures and regular sustained training of this motor control against a variety of challenges. Multiple reps of 5-6 second holds should be performed on a daily basis. According to Man niche et al., up to three months may be required to achieve a long-lasting beneficial effect (Man niche et al., 1991).


Summary

In conclusion, nonsurgical spinal decompression provides a method for physicians to properly apply and direct the decompressive force necessary to effectively treat discogenic disease. With the biotechnological advances of spinal decompression, symptoms were restored by subjective report in 86% of patients previously thought to be surgical candidates and mechanical function was restored in 92% using objective data. Ninety days after treatment only 2% reported pain and 3% relapsed, by physical examination exhibiting motor limitations and decreased spinal range of motion. Our results indicate that in treating 219 patients with MRI-documented disc herniation and degenerative disc diseases, treatment was successful as defined by: pain reduction; reduction in use of pain medications; normalization of range of motion, reflex, and gait; and recovery of sensory or motor loss. Biotechnological advances of spinal decompression indeed reveal promising results for the future of effective management of patients with disc herniation and degenerative disc diseases. The cost for successful nonsurgical therapy is less than a tenth of that for surgery. Long-term outcome studies are needed to determine if nonsurgical treatment prevents later surgery or merely delays it.

Thomas A. Gionis, MD, JD, MBA, MHA, FICS, FRCS, is chairman of the American Board of Healthcare Law and Medicine, Chicago; a diplomate professor of surgery, American Academy of Neurological and Orthopaedic Surgeons; and a fellow of the International College of Surgeons and the Royal College of Surgeons.

Eric Groteke, DC, CCIC, is a chiropractor and is certified in manipulation under anesthesia. He is also a chiropractic insurance consultant, a certified independent chiropractic examiner, and a certified chiropractic insurance consultant. Groteke maintains chiropractic centers in northeastern Pennsylvania, in Stroudsburg, Scranton, and Wilkes-Barre.

References

  1. Eyerman E. MRI evidence of mechanical reduction and repair of the torn annulus disc. International Society of Neuroradiologists; October 1998; Orlando.
  2. Narayan P, Morris IM. A preliminary audit of the management of acute low back pain in the Kettering District. Br J Rheumatol. 1995;34:693-694.
  3. McDevitt C. Proteoglycans of the intervertebral disc. In: Gosh, P, ed. The Biology of the Intervertebral Disc. Boca Raton, Fla: CRC Press; 1988:151-170.
  4. Bogduk N, Twomey L. Clinical Anatomy of the Lumbar Spine. New York: Churchill Livingstone; 1991.
  5. Cox JM. Low Back Pain: Mechanism, Diagnosis, and Treatment. 5th ed. Baltimore: Williams & Wilkins; 1990:69-70, 144.
  6. Cyriax JH. Textbook of Orthopaedic Medicine: Diagnosis of Soft Tissue Lesions. Vol 1. 8th ed. London: Balliere Tindall; 1982.
  7. Nachemson AL. The lumbar spine, an orthopaedic challenge. Spine. 1976;1(1):59-69.
  8. Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurgery. 1994;81:350-353.
  9. Shealy CN, Leroy P. New concepts in back pain management: decompression, reduction, and stabilization. In: Weiner R, ed. Pain Management: A Practical Guide for Clinicians. Boca Raton, Fla: St Lucie Press; 1998:239-257.
  10. Pal B, Mangion P, Hossain MA, et al. A controlled trial of continuous lumbar traction in back pain and sciatica. Br J Rheumatol. 1986;25:181-183.
  11. Weber H. Traction therapy in sciatica due to disc prolapse. J Oslo City Hosp. 1973;23(10):167-176.
  12. Yong-Hing K, Kirkaldy-Willis WH. The pathophysiology of degenerative disease of the lumbar spine. Orthop Clin North Am. 1983;14:501-503.
  13. Matthews J. The effects of spinal traction. Physiotherapy. 1972;58:64-66.
  14. Goldfish G. Lumbar traction. In: Tollison CD, Kriegel M, eds. Inter-
  15. disciplinary Rehabilitation of Low Back Pain. Baltimore: Williams & Wilkins; 1989.
  16. Onel D, Tuzlaci M, Sari H, Demir K. Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine. 1989; 14(1):82-90.

Decompression has provided relief for 86% of patients with herniated intervertebral disc (American Journal of pain management)

Manhattan Spinal Decompression, Non Surgical Disc Treatment, Herniated Disc treatment.

Dr. Steven Shoshany offers Spinal Decompression in his New York City, Manhattan office. Offering both Cervical and Lumbar Disc Decompression in the New York area.

About the DRX 9000

The DRX 9000 uses state of the art technology to gradually relieve neurocompression often associated with lower back pain. The process has been proven to relieve pain by enlarging intra-discal space, reducing herniation, strengthening outer ligaments to help move herniated areas back into place, and reversing high intradiscal pressure through application of negative pressure.

What to expect with treatment on the DRX 9000

Your, DRX 9000 treatment begins with a series of daily sessions for two weeks, followed by treatments three times a week as needed. Each session consist of 30-45 minutes on the DRX 9000. Following each therapy session, a cold pack with electrical muscle stimulation is applied to help Para vertebral muscles consolidate after treatment.

An upper chest harness/ shoulder support is used to help distribute the applied forces evenly. Once in place, you are slowly reclined to a horizontal position. Following the physician's orders, the therapist localizes the pain, makes any adjustments and directs the treatment to the proper area. DRX 9000 helps to mobilize the troubled disc segment without introducing further damage to the spine.

The DRX 9000 provides a program of treatment for relief from pain for those patients suffering wit low back pain. Under physician direction each treatment consist of a prescribed treatment period on the DRX 9000 to provide intermittent cycling distraction forces to relieve pressure on structures that may be causing low back pain.

Pain associated with herniated discs, protruding discs, degenerative disc disease, posterior facet syndrome and sciatica will respond. It achieves these affects through decompression of intervertebral discs.

What results can I expect from the DRX 9000

After only three weeks of treatment, clinical studies have shown outstanding results in relieving the debilitating pain that may be caused by bulging, herniated, degenerative, or ruptured discs, as well as sciatica, posterior facet syndrome, and many failed back surgery cases.

Pre and post MRIs have shown greater that 50% reduction in the size and extent of herniations after four weeks of treatment with the DRX 9000.

In fact, during the initial clinical study more than 82% of patients report relief of back pain with the DRX 9000.

·Herniated/Bulging Discs

·Degenerative Disc Disease

·Sciatic Leg Pain

·Facet Syndrome

·Post Surgical Back Pain

·Foramenal Stenosis

What causes low back pain?
Low back pain can be caused by a number of factors from injuries to the effects of aging.The spinal cord is protected by the vertebrae, which are made of bone. Between each vertebra are soft discs with a ligamentous outer layer. These discs function as shock absorbers to protect the vertebra and the spinal cord. Many of the problems that cause back pain are the result of herniation and degeneration of the intervertebral disc. Degeneration is a process where wear and tear causes deterioration of the disc. Herniations, or bulging of the disc are protrusions from the disc that press on surrounding nerves, causing pain or numbness.

How does the DRX 9000 separate each vertebra and allow for decompression at a specific level?
Decompression is achieved by using a specific combination of spinal positioning and varying the degree and intensity of force. The key to producing this decompression is the gentle pull that is created by a logarithmic curve. When distractive forces are generated on a logarithmic curve the typical proprioceptor response is avoided. Avoiding this response allows decompression to occur at the targeted area.

Can the DRX 9000 be used for patients that have had spinal surgery?
In most cases the DRX 9000 treatment is not contra-indicated for patients that have had spinal surgery. In fact many patients have found success with the DRX 9000 after a failed back surgery.

Is there any risk to the patient during treatment on the DRX 9000?
NO. The DRX 9000 is totally safe and comfortable for all subjects. The system has emergency stop switches for both the patient and the operator. These switches (a requirement of the FDA) terminate the treatment immediately thereby avoiding any injuries.

What is the difference between the DRX9000 and the VAX-D?
The DRX is three generations past the initial VAX-D table developed years ago. Actually, the former North American distributor of VAX-D is the present manufacturer of DRX who had requested upgrades to the VAX-D unit but was refused, which explains why the VAX-D hasn't changed in twenty years. So he and other decompression spinal practitioners brainstormed the problems with VAX-D, and with the help of many engineers, the DRX 9000 unit was developed just two years ago.

The most obvious differences between the DRX9000 and the VAX-D would be their success rate and the comfort levels while a patient is being treated. Below are some side by side comparisons.

DRX9000

  • 86% -89% Success Rate
  • Patient lays on back (supine)
  • Harnesses prevent any stress to the shoulders or arms.
  • The amount of decompression can be targeted to the specific disc level by varying the angle of traction.

    VAX-D
  • 72% Success Rate
  • Patient lies face down (prone) which can be very uncomfortable
  • Required patients had to hold on with their hands causing severe shoulder/arm problems
  • Nonspecific for disc levels with its straight-line traction

Did you get one of those golden paper Free reports? I did too, most of this information is false and overstated, and I felt it insulted my intelligence and any potential patients. In my practice I clearly point out that this treatment is not for everyone and that results are not guaranted. Spinal decompression is a fantastic way to treat patients with disc herniations but some patients are to far gone and need surgery, it is best to have your MRI report reviewed for a second opinion prior to getting a surgery for a possible Non-Surgical approach to treating the problem.

This study below is the most recent look into the effectiveness of Spinal Decompression using the DRX 9000

Effectiveness and Safety of Non-Surgical Spinal Decompression as presented at the American Academy of Pain Management AAPM 18th. Annual Clinical Meeting September 27-30, 2007

John Leslie MD, Charlotte Richmond, PhD, Alex Macario, MD, Christian Apfel, MD, Frank Florio,DC, Darren Clair, MD, Joseph Pergolizzi, MD

Mayo Clinc, Universty of California at San Francisco, John Hopkins University

EFFECTIVENESS & SAFET Y OF NON-SURGICAL SPINAL DECOMPRESSION

OBJECTIVE :Prospective, multi-center, phaseII, non-randomized clinical study to evaluate the effectiveness and safety of the Axiom Worldwide DRX9000 for active treatment of chronic LBP utilizing a standardized clinical research multimodal protocol.

METHODS: 20 patients with chronic LBP based on a diagnosis of musculoskeletal or mechanical LBP, herniated discs bulging or protruding discs, degenerative disc, pain from failed back surgery more than 6 months previously, posterior facet syndrome or sciatica underwent a series of 20 DRX treatments (28 mins each) for 6 weeks with 5 sessions the first week tapering to 1 session/wk. Treatment multimodal protocol included ice after DRX sessions, lumbar stretching exercises, and adjunct analgesics as required. Assessments of pain, analgesic use, functionality, satisfaction, activities of daily living and safety were collected through examinations, questionnaires and patient diaries.

RESULTS: 18 evaluable subjects (33.3%female,83.3% white, mean age 44.6, 77.8% employed) had mean pain score 5.8 on a 0 to 10 scale(0 = no pain 10 = worst pain) at initial presentation that decreased to 2.9 after last DRX treatment. Patients reported a mean 88.9% (16 out of 18) improvement in back pain, and a better function as measured by activities of daily living. On a ) to 10 scale (0 = not satisfied 10 = very satisfied) patients rated the DRX9000 an 8.1 . No patient required any invasive therapies (e.g. , epidural injections, surgery).

CONCLUSION: Overall, patients' pain improved immediately after DRX treatment, requiring fewer analgesics, with better function. There were no safety issues identified with multimodal treatment routine. Non-treatment or control groups were not included making efficacy outcome versus placebo or spontaneous recovery difficult to determine. Randomized double-blinded or comparative long-term outcome trials are needed to further prove the efficacy of the DRX9000 non-surgical spinal decompression system for the routine treatment of chronic LBP.

DISCLOSURE: This study was funded by Axiom Worldwide.

BACKGROUND

Paucity of literature on benefits of non-surgical spinal decompression over other non-surgical treatments

Previous studies are poorly designed

Results are descriptive in nature

Efficacy versus placebo or spontaneous recovery difficult to determine

Over 1,200 DRX9000 in use today

MATERIALS & METHODS

METHODS

Prospective, multi-center, Phase II , non-randomized clinical trial

3 free- standing clinics (2 MDs and 1DC)

Diagnosis: Low back pain > 12 weeks

Outcome measures assessed:

Daily Pain Diary

Verbal Rating Scale (VRS)

Oswestry Pain Questionnaire

Adverse Events

Satisfaction Survey

TREATMENT PROTOCOL

DRX9000 sessions

28 minute sessions for 6 weeks

Total of 20 treatments

5 sessions week 1&2

3 sessions week 3&4

2 sessions week 5&6

Additional Therapy

Ice therapy post DRX

Back exercises after week 2

FAILED THERAPY PRIOR TO DRX9000

PROCEDURE

#

procedure

#

procedure

CHIROPRACTIC

16

TENS

5

Facet injections

1

MUSCLE STIMULATION

10

ACUPUNCTURE

3

Ultra sound

1

ICE THERAPY

9

LUMBAR SUPPORT

3

Other Decompressive therapy

1

MASSAGE THERAPY

9

Epidural injections

3

ADVERSE EVENTS

Adverse Event

Related to device

Adverse Event

Related to device

Neck Pain

Possibly

Shoulder pain

No

Head cold (2)

No

LBP/flu like symptoms

No

Sinus headache 2)

No

Vertigo

No

Sinus Infection

No

Adrenal Insufficiency

No

Week 3

Week 6

Would you recommend DRX9000 to anyone else?

7.6

8.1

Yes88.9%

No 11.1%

www.drshoshany.com

I have recently expanded my practiceto a 4,000 sq. ft facility dedicated to non-surgical spinal decompresson, I added a digital radiographic unit that will now allow me to measure pre and post disc heights. This can prove to the patient that the spinal decompression treatment has increased the disc height. I also added the spineforce which is a fantastic machine that strengthens core muscles.

http://video.google.com/videoplay?docid=6782846266903430629&hl=en

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