Ambulatory traction

Abstract

A device and method for applying intermittent passive traction (IPT) that includes an initial phase followed by a sustained traction phase and finally a relaxation phase. During the first phase of IPT, the spinal elements are placed under gentle traction. This period of time reduces the normal forces across the vertebral bodies, facet joints, paraspinal musculature, etc. The second phase holds the spine in sustained traction, further reducing the forces across the spinal elements, encouraging natural healing to occur and allowing the muscles a period of relaxation. The third phase includes the gradual reduction of traction. During this final phase, the normal forces across the spine are reestablished as the IPT device slowly releases traction. The method resolves many of the most limiting problems associated with traction, CPM, and passive treatment modalities.

1 - 26 . (canceled) 
   
   
       27 . An ambulatory cervical spinal unloading apparatus configured to provide a desired amount of traction force to a spine of a patient and to absorb an intermittent and/or unexpected shock and/or vibration, with the traction force provided via a plurality of lifter assemblies, comprising:
 an upper jaw collar;   a lower support collar;   a residual cushioning device; and   the plurality of lifter assemblies;   wherein the plurality of lifter assemblies each independently expands or retracts to control distance between the orthotic belts to provide the traction force to a cervical portion of a spine of a patient, and each of the lifter assemblies further comprises a residual cushioning device that independently provides a desired residual cushioning effect by compression of a spring and/or damper to thereby absorb an intermittent and/or unexpected shock and/or vibration, wherein the spring and/or damper is effective to provide the residual cushioning for the lifting assembly in a deactivated state.   
   
   
       28 . The apparatus of  claim 27  with the lifter assemblies each comprising a worm gear tuning a threaded rod or a piston actuated fluidic lifting device. 
   
   
       29 . The apparatus of  claim 28 , with at least one of the lifter assemblies comprising a piston actuated fluidic lifting device. 
   
   
       30 . The apparatus of  claim 29  wherein the piston actuated fluidic lifting device comprises a pneumatically operated piston. 
   
   
       31 . The apparatus of  claim 29  wherein the piston actuated fluidic lifting device comprises a pair of pistons connected by a piston rod, and with each piston fitting a pneumatic cylinder. 
   
   
       32 . The apparatus of  claim 31  her comprising a gel-filled chamber that provides the residual cushioning. 
   
   
       33 . The spinal unloading apparatus according to  claim 27 , wherein at least one orthotic belt comprises integrated electrodes selectively positioned to provide a desired level of muscle or nerve stimulation in response to a desired electrical bias. 
   
   
       34 . The apparatus of  claim 27  further comprising a plurality of contact electrodes to deliver transcutaneous electrical nerve stimulation. 
   
   
       35 . The apparatus of  claim 27  wherein the upper orthotic belt and/or the lower orthotic belt comprises a plurality of contact electrodes to deliver transcutaneous electrical nerve stimulation. 
   
   
       36 . The spinal unloading apparatus according to  claim 27 , wherein the residual cushioning device comprises a gel-filled chamber. 
   
   
       37 . The spinal unloading apparatus according to  claim 27 , wherein the residual cushioning device comprises the spring. 
   
   
       38 . The spinal unloading apparatus according to  claim 27 , wherein the residual cushioning device comprises the damper. 
   
   
       39 . The spinal unloading apparatus according to  claim 27 , wherein each of the plurality of lifter assemblies comprises no more than one fluidic chamber. 
   
   
       40 . The spinal unloading apparatus according to  claim 27 , wherein the plurality of lifter assemblies each comprise at least one electric motor configured in combination with a mechanical extension shaft assembly to selectively control the distance. 
   
   
       41 . The spinal unloading apparatus according to  claim 40 , wherein the mechanical extension shaft assembly comprises at least one element selected from the group consisting of belts, pulleys, cables, threaded shafts, and gears. 
   
   
       42 . The spinal unloading apparatus according to  claim 41 , further comprising a hot pack. 
   
   
       43 . The spinal unloading apparatus according to  claim 27 , further comprising a recording apparatus operational to selectively record desired information associated with at least one parameter selected from the list consisting of traction, spinal unloading, stimulation, and/or therapeutic parameters. 
   
   
       44 . A method of spinal unloading comprising:
 providing an ambulatory spinal unloading apparatus that comprises a first collar, a second support collar, and a plurality of lifter assemblies configured to selectively vary a distance between the collars comprising a residual cushioning device that provides a desired residual cushioning effect achieved by compression of a spring and/or damper to thereby absorb an intermittent and/or unexpected shock and/or vibration for at least one of the lifter assemblies in a deactivated state.   
   
   
       45 . The method of  claim 44  further comprising providing transcutaneous electrical nerve stimulation through a plurality of contact electrodes. 
   
   
       46 . The method of  claim 44  further comprising providing transcutaneous electrical nerve stimulation through a plurality of contact electrodes located on the upper collar or the support collar. 
   
   
       47 . The method of  claim 46  further comprising providing a heat source in combination with the transcutaneous electrical nerve stimulation. 
   
   
       48 . The method of  claim 46 , with at least one of the lifter assemblies comprising a piston actuated fluidic lifting device that comprises a pneumatically operated piston. 
   
   
       49 . The method of  claim 46  wherein the piston actuated fluidic lifting device comprises a pair of pistons connected by a piston rod, with each piston fitting a pneumatic cylinder, and further comprising supplying a gas to one of the cylinders for moving the piston rod.