IVSAATT
Manipulation under anesthesia (MUA) is a type of non-surgical treatment that has been used for spinal pain and dysfunction for over 50 years. This treatment involves the administration of a sedative, anesthetic, or analgesic medication by a medical physician prior to spinal mobilization and manipulation, usually performed by a chiropractor. Proponents believe that administering the medication allows patients to better tolerate manual therapies that may otherwise be uncomfortable or painful.
Intravenous Sedation Analgesia Assisted Traction Therapy (IVSAATT) is a derivative of MUA developed by Drs. Jim Wooley and Chris Kemper. IVSAATT is performed under conscious sedation rather than general anesthesia, and is thus perceived as safer. Although the treatment protocol for IVSAATT is similar to that taught for MUA certification, the addition of internal coccyx mobilization is likely unique to this apporach. This component of the IVSAATT protocol stems from the belief that repeated falls and trauma to the coccyx area may lead to the formation of sacrococcygeal scar tissue and dysfunction. This may in turn contribute to low back pain and stiffness.
To investigate the efficacy of this treatment approach for chronic low back pain, an observational cohort study was conducted. Patients with low back pain of greater than 3 months’ duration whose low back pain was felt to be related to a lack of motion in the lumbar spine and coccyx were recruited into the study. After undergoing 4 to 6 weeks of conservative care including spinal manipulation, massage, stretching and exercises, a re-evaluation was performed to determine whether to proceed with IVSAATT. Patients who had failed to improved sufficiently with conservative care received 1 to 3 IVSAATT treatments as well as 4 to 6 weeks of follow-up care prior to being discharged from the study. Patient outcomes were measured using the Outcomes Data Collection Questionnaires developed by the American Academy of Orthopaedic Surgeons (AAOS), North American Spine Society (NASS) and others. Outcome measures included general health assessment, lumbar spine pain and disability, satisfaction with care and range of motion and were measured at baseline, 4 to 6 week re-evaluation, 3 months, 6 months and 12 months. Patient recruitment was completed in 2001. Data collection was completed in 2002. Results from this study have been presented at various professional conferences, and published in a recent research article in a peer-reviewed scientific journal.