Clinical Efficacy of Dynamic Sustained Versus Static Intermittent Lumbar Traction for Lumbar Spinal Stenosis: A Systematic Review

Pushpendra Yaduvanshi; Vinay Gulati

doi:10.36948/ijfmr.2026.v08i04.84326

Clinical Efficacy of Dynamic Sustained Versus Static Intermittent Lumbar Traction for Lumbar Spinal Stenosis: A Systematic Review

Author(s)	Prof. Dr. Pushpendra Yaduvanshi, Mr. Vinay Gulati
Country	India
Abstract	Background Lumbar spinal stenosis (LSS) commonly causes neurogenic claudication, and lumbar traction remains widely used despite guideline uncertainty. Two traction philosophies—dynamic sustained traction (DST, continuous/slowly cycling force) and static intermittent traction (SIT, fixed load cycled on/off)—are applied clinically, but their comparative effectiveness specifically in LSS has not been systematically reviewed. Objective To systematically synthesize 2015–2025 evidence on DST versus SIT in conservative LSS management. Methods PRISMA 2020-guided search of PubMed/MEDLINE, PMC, Embase-indexed sources, ScienceDirect, JOSPT, CINAHL, Cochrane Library, and PEDro, supplemented by guideline and registry hand-searching. Adults with LSS (or closely related nerve-root-compression cohorts where LSS-specific data were unavailable) receiving a traction or traction-adjacent intervention with an extractable outcome were eligible. Risk of bias in RCTs was appraised using a Cochrane RoB2-informed approach; narrative synthesis was used given clinical/methodological heterogeneity. Results Of 859 records identified, 14 studies (8 RCTs, 3 prospective cohort/pilot, 2 retrospective cohort, 1 contextual guideline) met eligibility. No study directly compared DST against SIT within an LSS-diagnosed population—the review's principal finding. The closest evidence, from nerve-root-compression and flexion-distraction literature, showed no consistent superiority of either modality; one well-powered RCT found no added benefit of intermittent traction over extension exercise alone. Flexion-biased, dynamically applied distraction in LSS-specific cohorts showed modest, generally short-term functional gains but was confounded by concurrent manual therapy/exercise. Adverse events were infrequent, mostly transient symptom aggravation. Conclusion Evidence is insufficient to recommend DST over SIT, or vice versa, for LSS. This reaffirms existing guideline positions and highlights a clear research gap: an adequately powered RCT directly randomizing LSS patients to DST versus SIT, with walking capacity as a primary outcome, is needed.
Keywords	lumbar spinal stenosis; neurogenic claudication; lumbar traction; dynamic sustained traction; static intermittent traction.
Field	Medical / Pharmacy
Published In	Volume 8, Issue 4, July-August 2026
Published On	2026-07-24
DOI	https://doi.org/10.36948/ijfmr.2026.v08i04.84326

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Clinical Efficacy of Dynamic Sustained Versus Static Intermittent Lumbar Traction for Lumbar Spinal Stenosis: A Systematic Review

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