A Call for Chiropractic Continued from Page 24 published up to November 2004 was conducted, and subsequently analyzed, including an article specifically dealing with one particular company’s non-surgi- cal decompression device. The authors of the Cochrane Review expressed their dis- Canada is still in the emergent stage with respect to N-SSD, with the chiropractor being the first to adopt the technology. may regarding the quality of these stud- ies by stating, “…most available studies have methodological problems, with the potential for biased results.” They go on to offer guidance for future research by suggesting that, “Any future research … be carried out according to the highest methodological standards to avoid po- tential bias.” 44 • CANADIAN CHIROPRACTOR | APRIL 2008 In 2006, another study – this time car- ried out by supporters of the chiropractic profession – entitled, “Systematic Litera- ture Review of Spinal Decompression Via Motorized Traction for Chronic Discogenic Low Back Pain” reviewed and analyzed all literature published between 1975 and October 2005. The authors of this study expressed many of the same concerns that were discussed in the Cochrane Col- laboration article by noting, “Because the overall quality of studies was low and the patient groups were heterogeneous – e.g., grouped by symptom duration and diag- noses – a meta-analysis was not appropri- ate and a qualitative review was under- taken.” As a result, the authors concluded, “The evidence for the effi cacy of motorized spinal decompression for discogenic lum- brosacral back pain remains inconclusive. Scientifi cally more rigorous studies with better randomization, more complete control groups, uniform selection crite- ria, evidence-based diagnostic measures, and standardized outcome measures are needed to identify the best responders to this conservative intervention.” In 2007, Dwain M. Daniel, of the Parker Research Institute, Parker College of Chi- ropractic, published an article titled, “De- bate, Non-surgical spinal decompression therapy: does the scientifi c literature sup- port effi cacy claims made in the advertis- ing media?” Although the majority of the studies discussed in this article are based on one specifi c manufacturer’s N-SSD unit, the author does state that his article is not a systematic review of the literature. None- theless, he does come to many of the same conclusions mentioned above regarding outcome measures, study design, bias, etc. THE IDEA Even though there is criticism regarding the quality of the studies conducted prior to October 2005, the data from these stud- ies, along with strong anecdotal evidence, do show promising results in treating back pain with non-surgical spinal decom- pression. However, mediocre studies www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor April 2008: Page 44
