title: Herniated Lumbar Disks: Real-time MR Imaging Evaluation during Continuous Traction.
abstract: OBJECTIVE
  To assess the morphologic changes in herniated lumbar intervertebral disks and surrounding structures during lumbar traction by using real-time magnetic resonance (MR) imaging.
  
  
  METHODS
  This prospective study was approved by the institutional review board, and written informed consent was obtained from all participants. Forty-eight consecutive patients with lumbar disk herniation (13 men and 35 women) were treated with continuous lumbar traction by using a nonmagnetic traction device. Real-time MR imaging of the lumbar spine was performed before the initiation of traction and at 10-minute intervals during 30 minutes of 30 kg of continuous traction. Sagittal and axial MR images were analyzed to determine qualitative changes during lumbar traction. Quantitative changes caused by traction on the lumbar spine were determined by measurement of lumbar vertebral column elongation and the disk reduction ratio.
  
  
  RESULTS
  Continuous traction on herniated lumbar disks and surrounding structures resulted in change in disk shape, disk reduction with opening in the intervertebral disk, reduction of herniated disk volume, separation of the disk and adjoining nerve root, and widening of the facet joint. Both the mean lumbar vertebral column length (elongation of 1.45% after 30 minutes, P < .001) and the mean disk reduction ratio (8.57%, 15.24%, and 17.94% after 10, 20, and 30 minutes of traction, respectively) increased with time of traction.
  
  
  CONCLUSIONS
  The results of this study demonstrated that the real-time effects of continuous traction on herniated lumbar intervertebral disks and their surrounding structures can be visualized by using MR imaging.
authors.affiliation: From the Department of Radiology (T.S.C., S.J.A.) and Department of Rehabilitation Medicine, Rehabilitation Institute of Neuromuscular Disease (J.H.P.), Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul 135-720, Korea; and Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea (H.E.Y.).
authors.forename: Tae-Sub
authors.initials: TS
authors.lastname: Chung
authors.forename: Hea-Eun
authors.initials: HE
authors.lastname: Yang
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Ahn
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000628:therapy*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014143:Traction; D055815:Young Adult