Clinical studies
Featured IDD Therapy® Spinal Decompression Clinical Studies

Oscillation & Oscillatory signaling in IDD Therapy® & the Accu-SPINA®
Author: Busch D.C., et al
Affiliation: Indiana University, Parker University
Publication: Journal of Rehabilitation Therapy

IDD Therapy Non-Surgical Spinal Decompression Study
Author: Ekediegwu, D.P.T.
Affiliation: Nnamdi Azikiwe University
Publication: Journal of Spine

Nonsurgical Spinal Decompression Effective on Neck Back Pain
Author: Henry, D.C.
Affiliation: Sherman College
Publication: Journal of Novel Physiotherapy and Physical Rehabilitation

IDD Therapy: A New Direction for Treating Low Back Pain
Author: McClure, MD
Affiliation: Indiana University School of Medicine
Publication: U.S. Musculoskeletal Review

Stress in Lumbar Intervertebral Discs During Distraction
Author: Gay M.D., et al
Affiliation: Mayo Clinic
Publication: The Spine Journal

Long Term Effect of IDD Therapy in Low Back Pain
Author: Shealy, MD,PhD
Affiliation: Duke University-Harvard Fellow
Publication: American Journal Pain Management

IDD Therapy in Back Pain Treatment: A Clinical Trial..
Author: Shealy, MD,PhD
Affiliation: Duke University-Harvard Fellow
Presentation to: Southern Medical Association
Clinical Literature:
Accu-SPINA® Nonsurgical Spinal Decompression System

Oscillation & Oscillatory signaling in IDD Therapy® & the Accu-SPINA®
Full Title: A Single Session of Spinal Decompression with Oscillation and Videofluoroscopy
Author: Busch D.C., et al
Affiliation: Indiana University, Parker University
Publication: Journal of Rehabilitation Therapy
Background: Computerized spinal decompression using the intervertebral differential dynamics (IDD) therapy protocol has achieved 86–92% positive results in reducing back pain. There are many causes of back pain, and one of the most common is a degenerative disc. The etiology of a degenerative disc is not completely understood, but it can be related to acute injuries, repetitive stress, nutrition, genetic factors, and oxidative stress1. Standard of care may include physical therapy or manipulation to introduce movement to the spinal vertebrae. IDD Therapy® uses a calculated, sinusoidal, logarithmic primary waveform to separate the spinal vertebrae. More recent studies have shown that the addition of a secondary waveform gives a significant increase in efficacy. We observed these effects on the spine during an IDD Therapy® session.
Learn More: IDD Therapy Advanced Spinal Decompression

IDD Therapy Non-Surgical Spinal Decompression Study
Full Title: Reduction in Chronic Low Back Pain Using Intervertebral Differential Dynamics Therapy (IDDT) and Routine Physiotherapy: A Retrospective Pre-Post Study
Author: Ekediegwu, D.P.T.
Affiliation: Nnamdi Azikiwe University
Publication: Journal of Spine
Background: The plethora of treatments for Low Back Pain (LBP) has increased in recent times. Opioids, spinal injection, bed rest, skin traction and surgery have remained the common forms of treatment. However, there is less emphasis on pharmacological and surgical treatments in national clinical practice guidelines. Non-surgical Spinal Decompression (NSD) is a modern, though investigational non-surgical treatment technique for LBP. The aim of this report was to analyse the outcome of LBP using NSD technique delivered by an Intervertebral Differential Dynamics Therapy (IDDT) device amidst other conservative treatments.
Learn More: IDD Therapy Advanced Spinal Decompression

The Best Non-surgical Cervical and Lumbar Pain Treatment
Full Title: The best non-surgical treatment for cervical and lumbar pain in the world
Author: Liang, Wenrui
Affiliation: Guangxu Hospital
Type: Case Study
Opening Statement: The rehabilitation medicine department of our hospital introduced the first non-surgical treatment of cervical and lumbar spondylosis “non-surgical spinal decompression system”. The system is recognized as the best non-surgical treatment system for cervical, lumbar and back pain in the world. It is a safe, painless, non-invasive and efficient non-surgical physical therapy method, which provides a new non-surgical treatment technology for patients with lumbar and cervical spondylosis. Clinical studies have shown that the success rate of this system in the treatment of patients with spine related pain is as high as 92% (cervical spine) to 93% (lumbar spine)
Learn More: IDD Therapy Advanced Spinal Decompression

Role of IDD Therapy in Back and Neck Pain
Full Title: Role of IDD Therapy in Back and Neck Pain
Author: Patnaik, MD
Affiliation: University of Nagpur, India
Publication: HSOA Journal of Medicine
Excerpt: How does IDD ( Intervertebral Differential Dynamics (IDD) Therapy) work? An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibro cartilaginous joint (a symphysis), to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together. Intervertebral discs rely on movement and pressure differentials for hydration and nutritional pathways. Compression is the number one enemy of the intervertebral disc and that is why “decompression” has always been appealing and why releasing pain to allow movement in the vertebral joints is a key objective of any spinal treatment.
Traction in one form or another has been around for centuries but the technology and knowledge of the spine has only taken off in the last 20 years to enable the treatment to evolve. Opening targeted spinal segments to create negative pressure is what separates IDD Therapy spinal decompression from traditional traction. IDD Therapy is not a cure all, but it is a highly effective treatment tool which, when used as part of a complete program of care, offers clinicians the opportunity to tackle back pain, neck pain and in particular, disc-related conditions in a manner previously not possible.

Non-Surgical Spinal Decompression MRI Evidence Case Studies
Full Title: Non-Surgical Spinal Decompression MRI Evidence Case Studies
Author: Henry D.C., Kaplan D.C
Affiliation: Parker University
Type: Case Studies
Description: The authors evaluate MRIs from patients who had IDD Therapy® treatment on the Accu-SPINA® system to treat cervical and lumbar issues. Improvements are described and shown using graphs.

Nonsurgical Spinal Decompression Effective on Neck Back Pain
Full Title: Nonsurgical Spinal Decompression an Effective Physiotherapy Modality for Neck and Back Pain
Author: Henry, D.C.
Affiliation: Sherman College
Publication: Journal of Novel Physiotherapy and Physical Rehabilitation
Background: Nonsurgical spinal decompression is a novel physiotherapy that improves on conventional traction by adding computer technology and it is commonly used along with other physiotherapy modalities. Indications include bulging or herniated discs, degenerative disc disease, facet syndrome, sciatica, neck pain and lower back pain.
The purpose of this practice-based observational study was to investigate the effectiveness of decompression for patients with radiculopathy or chronic spinal pain that failed to improve with conventional treatments….

Effect of Spinal Decompression on the Lumbar Muscle & Discs
Full Title: Effect of Spinal Decompression on the Lumbar Muscle and Disc Height in Herniated Intervertebral Disc Patients
Author: Kang Choi
Affiliation: Sehan University
Publication: Journal of Physical Therapy Science
Abstract: This study was conducted to clarify the difference in therapeutic effects between traction and decompression therapies, and their clinical therapeutic significance. The subjects were 31 patients aged 35 to 50 years who had unilateral or bilateral lumbar and radicular leg pain. An intervention program was implemented in 31 patients with lumbar herniated intervertebral disks. For the experimental group, 15 subjects were randomly selected to receive decompression therapy and trunk stabilization exercise. For the control group, 16 subjects were randomly selected to receive traction therapy and trunk stabilization exercise…

Study of Patient Outcomes with Treatment on the Accu-SPINA® System
Full Title: An Evaluative Study of Patient-Based Outcomes with Treatment on the Accu-SPINA® System
Author: Manella, D.C
Affiliation: Logan University
Type: Independent Study
Opening: The treatment under evaluation in this study is called IntraDiscNutrosis® (a program including IDD Therapy® using the Accu-SPINA® system), a non-surgical therapeutic intervention for patients with bulging, herniated, degenerative discs and other discogenic disorders. These conditions result in substantial back and/or neck pain, radiculopathies and extremity pain and/or numbness, along with associated disabilities and functional limitations. What distinguishes this treatment from other forms of treatment (e.g., physical therapy, surgery, chiropractic, epidural injections, pain management, exercise, stretching, yoga, Pilates, weight loss, etc.) is that (a) it non-invasively and specifically treats the disc directly, and the associated pain indirectly; (b) it treats the problem of why the disc is dying, instead of treating the conditions or symptoms that manifest from a dying disc; …

Conservative Treatment Approaches in Low Back Pain, IDD..
Full Title: Conservative Treatment Approaches in Low Back Pain, IDD Observational Study…
Author: Smith PT-MCSP
Affiliation: University of Exeter
Type: Observational Study
Introduction: A prospective outcome study was conducted on patients with chronic low back pain due to degenerative disc disease, herniated nucleus pulposus and facet arthropathy. Between March 2003 and January of 2004, ten physicians in private practices across the United States, with a high volume of patients with spinal disorders, participated in this study. Specialties included Internal Medicine, Rheumatology, Neurology, Orthopedic, and Pain Management. Prior to entering the study, the patients were evaluated by the physician and diagnosed with a painful lumbar degenerative condition based on history and physical and appropriate imaging studies. Prior to each treatment, the patients completed an Oswestry Disability Index (ODI) questionnaire. The ODI scores range from 0-50. A change of more than 4 points is considered clinically meaningful. Each patient was treated for 25 min with decompression.

IDD Therapy: Evolving Conservative Spinal Treatment…
Full Title: IDD Therapy: Evolving Conservative Spinal Treatment Modalities
Author: Wood,P.T-MCSP
Affiliation: University of Exeter
Publication: Spinal Surgery News
Opening Statement: As part of conservative care, IDD Therapy® spinal decompression is emerging as an invaluable tool for physiotherapists treating chronic herniated disc conditions and related symptoms such as radicular pain and radiculopathy. Developed to address the failings of traditional traction, IDD Therapy combines mechanical decompression with exercise to form a program of spinal rehabilitation which significantly improves pain and function in lumbar and cervical patients.
Applying computer-controlled pulling forces at precisely measured angles, clinicians are able to distract and mobilize and thus decompress targeted spinal segments with greater precision and adequate force than previously possible with traction. With referrals from GPs, pain consultants and surgeons, UK clinicians report 70–90% success rates in selected patients – many of whom have exhausted manual and invasive procedures. This article examines some of the physiological mechanisms which may contribute to the clinical outcomes in IDD Therapy patients.

Article: IDD Therapy®
Author: Lansdale, DO
Affiliation: University of Exeter
Publication: Osteopathy Today
Opening Statement: Intervertebral Differential Dynamics (or IDD) Therapy was first drawn to my attention by the late osteopath, Simon Lichtenstein and his wife, Sally Lansdale, who is also an osteopath, when I bumped into them at a BOA conference in 2009. Interested in the potential of the technology and looking for a solution to Sally’s own unresolved back problems, they had just decided to invest in an IDD machine for their practice in Leominster, Herefordshire.
Knowing them to be respected “hands on” osteopaths with over 30 years’ experience (they both qualified from the BSO in the early 80s), I was curious about their decision to invest a not inconsiderable sum in something that sounded rather like a rhythmic traction device and thought it might be helpful to other osteopaths to find out more.

IDD Therapy vs. Exercise Based Physical Therapy
Full Title: Intervertebral Differential Dynamics (IDD) Therapy vs. Exercise Based Physical Therapy
Author: Schaufele, MD
Affiliation: Harvard Medical School & Emory University
Publication: Physical Medicine Rehabilitation
Objective: To compare the effectiveness of Intervertebral Disc Dynamics Therapy, also know as, IDD Therapy, with an exercise-based physical therapy program in patients with chronic low back pain caused by degenerative disc disease. Method: 48 patients with chronic low back pain > 3 months secondary to mild to moderate degenerative disc disease were included. Patients were randomized in a 2:1 ratio to IDD therapy or a physical therapy program based on lumbar stabilization exercises (PT). Patients in both groups had to complete a minimum of 6 treatments over a 6-week period.

Trunk Muscle Response to Various Protocols of Lumbar Traction
Full Title: Trunk Muscle Response to Various Protocols of Lumbar Traction
Author: Cholewicki MD
Affiliation: Yale University
Publication: Journal of Manual Therapy
Abstract: The purpose of this study was to compare trunk muscle activity, spinal decompression force, and trunk flexibility resulting from various protocols of spinal traction. Four experiments explored the effects of sinusoidal, triangular, square, and continuous distraction-force waveforms, 0, 10, 20, and 30 degrees of pull angle, superimposed low, medium and high frequency force oscillations, and sham traction.
Nineteen healthy subjects volunteered for this study. Surface EMG was recorded during traction and later used in a biomechanical model to estimate spine decompression force. Trunk flexibility was measured before and after each treatment.

IDD Therapy: a Non-invasive Approach
Full Title:
Presentation: IDD Therapy: a Non-invasive Approach In The Treatment Of Low Back Pain
Author: McClure, MD
Affiliation: Indiana University School of Medicine
Presentation to: American Association Neurological Surgeons
Abstract Introduction: Back pain is a perception caused by tissue injury producing an emotional response.IDD therapy can assist the Neurosurgeon in the initial treatment of low back pain due to degenerative disc disease, as well as patients with failed back syndrome. Patients who experience pain often have accompanying depression IDD therapy can significantly improve back pain in patients who have depression due to degenerative disc disease. We have treated over 1500 patients to date.

Disc Distraction Shows Evidence of Regenerative Potential
Full Title: Disc Distraction Shows evidence of Regenerative Potential in Degenerated Intervertebral Discs
Author: Guehring, MD
Affiliation: University of Heidelberg
Publication: The Spine Journal
Objectives: Effects of temporary dynamic distraction on intervertebral discs were studied on the lumbar spine rabbit model to characterize the changes associated with disc distraction and to evaluate feasibility of temporary disc distraction to previously compressed discs in order to stimulate disc regeneration.

IDD Therapy: A New Direction for Treating Low Back Pain
Full Title: Intervertebral Differential Dynamics Therapy: A New Direction for the Initial Treatment of Low Back Pain
Author: McClure, MD
Affiliation: Indiana University School of Medicine
Publication(s): U.S. Musculoskeletal Review and European Musculoskeletal Review
Introduction: There has been no established uniform or conservative management to effectively treat low back pain. Patients with back pain usually present a neurosurgeon or spine specialist with an abnormal magnetic resonance imaging (MRI), while their referring physician tells them they have a degenerated disc causing their pain. Throughout my years of practice, it has become apparent to me that patients with back pain want to know why they are having pain, the cause of their back pain and how to effectively treat their back pain in order to avoid surgery. In addition to improving pain, another goal in treatment is to improve flexibility, as well as quality of life, in the safest and most effective manner prior to recommending more invasive procedures for treating the patient’s pain due to degenerative disc disease. It is a misconception by the public that surgery ‘fixes’ a person’s back pain. If this were true, we would never see patients with failed back syndrome.

Stress in Lumbar Intervertebral Discs During Distraction
Author: Gay M.D., et al
Affiliation: Mayo Clinic
Publication: The Spine Journal
Abstract: The intervertebral disc is a common source of low back pain (LBP). Prospective studies suggest that treatments that intermittently distract the disc might be beneficial for chronic LBP. Although the potential exists for distraction therapies to affect the disc biomechanically, their effect on intradiscal stress is debated.
Purpose: To determine if distraction alone, distraction combined with flexion, or distraction combined with extension can reduce nucleus pulposus pressure and posterior annulus compressive stress in cadaveric lumbar discs compared with simulated standing or lying.

Long Term Effect of IDD Therapy in Low Back Pain
Full Title: Long-Term Effect Analysis of IDD Therapy in Low Back Pain: A Retrospective Clinical Pilot Study
Author: Shealy, MD,PhD
Affiliation: Duke University-Harvard Fellow
Publication: American Journal Pain Management
Abstract: An analysis of the duration effect of intervertebral differential dynamics therapy (IDD Therapy®), to ascertain the benefits of rehabilitation treatment is presented. Patients from a private practice clinic were administered IDD Therapy®. The treatment was evaluated on 33 patients (17 females), using a numeric pain scale at the first session, last session, and at one year.

IDD Therapy in Back Pain Treatment: A Clinical Trial..
Full Title: IDD Therapy in Back Pain Treatment: A Clinical Trial Comparing Key Diseases of Low Back Pain
Author: Shealy, MD,PhD
Affiliation: Duke University-Harvard Fellow
Presentation to: Southern Medical Association
Introduction: Low back pain impacts more than 65 million Americans per year and ranks second only to headaches as the most frequent cause of pain. The most common site for back pain is the lower lumbar area because it bears the most weight and stress. Even though back pain is rarely life threatening, the annual cost in terms of lost productivity, medical expenses and workers’ compensation benefits runs into the tens of billions of dollars annually in the United States.

Poster Board Display IDD Therapy vs Physical Therapy
Full Title: Graphical Display as addendum to study of Intervertebral Differential Dynamics (IDD) Therapy vs. Exercise Based Physical Therapy – Initial Results from a Randomized Controlled Trial
Author: Schaufele, Michael K. MD, Newsome, Michael PT
Affiliation: Harvard Medical
Publication: American Journal of Physical Medicine & Rehabilitation
Background: Disc degeneration is probably the most common structural cause of chronic low back pain. Multiple nonsurgical treatment options exist, but few of them have undergone vigorous scientific evaluation. Recently, several advanced therapeutic modalities based on the principle of traction have been developed for this indication. These treatments are widely available, but are controversial because of the limited scientific evidence to support their claimed benefits.

A Focus on Nonsurgical Approaches to Chronic Low Back Pain
Full Title: Current Therapeutic Options for Chronic Low Back Pain: A Focus on Nonsurgical Approaches
Author: Shah, MD/ Schaufele MD
Affiliation: NY Medical/Harvard Medical
Study Focus: The Significant Impact of Low Back Pain
Opening paragraph: In recognition of the extreme burden and impact that musculoskeletal disorders have on society, the United Nations and the World Health Organization(WHO) have designated 2000 to 2010 as the Bone and Joint Decade. Musculoskeletal disorders—of which low back pain (LBP) is the most prevalent condition—are the most common cause of severe long term pain and physical disability. lnternational studies indicate that the percentage of people that experience LBP during their lifetime ranges from 58% to 84%, while point prevalence figures estimate that LBP affects an average of 30% of the population at any given time. Currently, there are approximately 10 million Americans disabled by LBP.

IDD Therapy For Treatment Of Lumbar Degenerative Disorders
Full Title: IDD Therapy For Treatment Of Painful Lumbar Degenerative Disorders
Author: Schaufele, MD
Affiliation: Harvard Medical School
Type: Study
The goal of this study is to evaluate the therapeutic effect of the new medical device, which is intended to give patients with chronic low back due to degenerative causes a non-surgical treatment alternative. IDD Therapy treatment uses controlled distraction of the affected lumbar spinal segments through a motorized cable/harness system to cause the decompression effect on the disk by creating a negative pressure within the disk. This negative pressure may increase the water content and the shock-absorbing qualities of the disk, which may result in decreased low back pain. Previous studies have demonstrated that forces in excess of 26% body weight have a distraction effect on the lumbar spine. 60-80 pounds of weight result in an average vertebral distraction of 0.2 mm per lumbar spinal segment.

IDD Therapy for Total Resolution after Failed Spinal Surgery
Full Title: IDD Therapy for Total Resolution of Posterior Disc Herniation after Failed Spinal Surgery
Author: Shalaby, MD
Affiliation: M.B.R. University of Medicine
Type: MRI Case Report
We studied the case of a 44-year old woman (…) with severe low back pain radiating to both lower limbs but more to the left side. She was asked by her surgeon to perform an M.R.I. which showed a large L4, L5 posterior & posterolateral disc herniation, she had an open discectomy at that time.
One year after the surgery she started to feel the pain again in the same area which gradually increased over the following two years, incapacitating her (bed bound). She was asked by her surgeon to perform a repeat discectomy with spinolaminectomy and release the adhesions. (…) She was treated with our ISYS treatment protocol, central part of this protocol is IDD Therapy®. The results show great improvement.

Technology Review: IDD Therapy
Author: Shealy,MD,PhD
Affiliation: Duke University-Harvard Fellow
Publication: Practical Pain Management
Technology & Study Overview: The author reviewed results reported from ten clinics, with a cohort of over 500 patients. Im provement rates of 65 to 88% confirm the author’s earlier findings regarding differential dynamic rehabilitation. Most importantly, the latest study demonstrates not only an average 65% decrease in pain at completion of IDD therapy, but average pain reduction of 76% one year after treatment
Current exploration of vibration, distraction, oscillation and other adjunctive mobilization adjustments offer even greater potential for the future of intervertebral differential dynamics rehabilitation.

Distraction Techniques For Lumbar Pain
Author: Ottenstein, MD
Affiliation: Hahnemann Univ. School of Medicine
Publication: Practical Pain Management
Introduction: At the dawn of the 21st century there are still a great many patients suffering from common lumbar pain syndromes. Fortunately, unlike just a few decades ago, we now have many treatments to help these patients. These treatments run the gamut from doing “nothing” (eg. bed rest or passive modalities only) to doing “every thing” (for example, open spinal surgery, discectomy, laminectomy, and/or interbody fusion).
Choosing an appropriate treatment for a particular patient, however, is a complex process. Unfortunately for all concerned, the exact diagnosis is rarely clear cut. Using only the anatomical information found on imaging studies such as MRI and CT, the physician typically has a very low probability of making the proper etiological diagnosis for lumbar pain.

MRI Evidence of Nonsurgical Repair of the Herniated Lumbar Disc
Full Title: MRI Evidence of Nonsurgical, Mechanical Reduction, Rehydration and Repair of the Herniated Lumbar Disc
Author: Eyerman, MD
Affiliation: Columbia Univ- N.I.H.
Presentation to: American Society of Neuroimaging
Abstract: Simple pelvic traction gives inconsistent relief to herniated lumbar disc sufferers. A new decompression table system applying fifteen 60-second tractions of just over one-half bod/ weight in twenty V-i hour sessions was reported to give good or excellent relief of sciatic and back pain in 86% of 14 patients with herniated discs and 73% of 8 with facet joint arthrosis. Herniated and degenerated lumbar discs can be shown at discography discomanometry to have elevated intradiscal pressures made even worse by sitting and standing, thus preventing proper disc nutrition. Therefore decompressing the over-pressurized disc should allow for healing and repair of disc prolapse, herniation and annulus tears. Serial MRI imaging of 20 patients treated with the decompression table shows in our study, over 90% reduction of subligamentous nucleus herniation in 10 of 14.

New Concepts in Back Pain Management
Full Title: New Concepts in Back Pain Management: Decompression, Reduction, and Stabilization
Authors: Shealy-LeRoy MD
Affiliation: Duke University-Harvard Fellow
Publication: Pain Management, A Practical Guide for Clinicians
Abstract: A thorough evaluation [review] of previous traction techniques reveals no consistent pattern in prior literature. We have evaluated a variety of devices and found that seven major factors are important in achieving optimal clinical results [in back pain management]. These include: (1) split table design to minimize effects of gravity; (2) flexion of the knees for hip relaxation; (3) controlled flexion of the lumbar spine during treatment which alters the location of distraction segmentally; (4) comfort and non-slippage of the pelvic restraining belt, (5) comfort and non-slippage of the chest restraint; (6) concomitant use of TENS, heat, ice, and myofascial release; and (7) a graduated limbering, strengthening, and stabilization exercise program. Using this system, successful pain control was achieved in 86% of patients studied with ruptured intervertebral discs and 75% of those with facet arthrosis.

A Cost-Effective Treatment for Lumbosacral Pain
Full Title: Decompression, Reduction, and Stabilization of the Lumbar Spine: A Cost-Effective Treatment for Lumbosacral Pain
Authors: Shealy,MD,PhD -Borgmeyer
Affiliation: Duke University-Harvard Fellow
Publication: American Journal of Pain Management
Introduction: Pain in the lumbosacral spine is the most common of all pain complaints. It causes loss of work and is the single most common cause of disability in persons under 45 years of age. Back pain is the most dollar-costly industrial problem. Pain clinics originated over 30 years ago, in large part, because of the numbers of chronic back pain patients. Interestingly, despite patients’ reporting good results using “upside-down gravity boots,” and commenting on how good stretching made them feel, traction as a primary treatment has been overlooked while very expensive and invasive treatments have dominated the management of low back pain.