Can Cervical Traction Be Safely Performed After MVD Surgery?

Can traction therapy for the cervical spine be performed after MVD (Microvascular Decompression)?

Hello Director Zhang, I apologize for the intrusion, but I have a question that only a senior physician can answer.
I would appreciate your guidance: Last year, my elder experienced aging of the right anterior inferior cerebellar artery (AICA), which compressed the vestibulocochlear nerve of the right ear, leading to pulsatile tinnitus.
They underwent microvascular decompression (MVD) surgery at a major hospital, using Teflon to separate the vessels.
Recently, due to right-sided sternocleidomastoid myofascitis affecting the upper cervical spine, they have been experiencing cervicogenic headaches.
The rehabilitation physician has suggested cervical traction, but we are unsure if this traction might displace the vessels that are resting on the Teflon.
The rehabilitation physician could not provide an answer, so I am seeking your advice.
Thank you once again.

Lao Chen, 40~49 year old female. Ask Date: 2016/10/20

Dr. Zhang Junwei reply Neurosurgery

No, cervical traction cannot cause Teflon displacement.

Reply Date: 2016/10/20

More Info

Cervical traction after microvascular decompression (MVD) surgery is a topic that requires careful consideration of the individual patient's condition and the specifics of their surgical procedure. In general, MVD surgery is performed to relieve pressure on cranial nerves, often using materials like Teflon to separate the offending blood vessels from the nerves. This procedure primarily addresses issues related to cranial nerve compression, such as hemifacial spasm or trigeminal neuralgia, and does not directly involve the cervical spine.

When it comes to cervical traction, it is essential to evaluate the patient's overall cervical stability and the nature of their post-operative condition. In your case, the patient has developed myofascial pain syndrome in the neck and upper cervical region, which is not uncommon after such surgeries due to altered biomechanics or compensatory mechanisms. The recommendation for cervical traction by the rehabilitation physician aims to alleviate neck pain and improve mobility.

The concern about whether cervical traction could displace the Teflon used during MVD surgery is understandable. However, it is important to note that the Teflon is typically secured in place and should not be affected by cervical traction. The traction primarily affects the cervical vertebrae and surrounding soft tissues, rather than the cranial structures or the materials used in MVD. Therefore, cervical traction is generally considered safe in this context, provided that the patient does not have any other contraindications.

That said, the decision to proceed with cervical traction should be made collaboratively between the patient, the rehabilitation physician, and the neurosurgeon. Factors such as the patient's overall health, the presence of any neurological deficits, and the specific details of the MVD surgery should all be taken into account. It may also be beneficial to monitor the patient closely during the initial sessions of traction to ensure that there are no adverse effects.

In summary, cervical traction can be safely performed after MVD surgery, but it is crucial to assess the individual patient's condition and ensure that there are no contraindications. The rehabilitation team should work closely with the neurosurgeon to develop a comprehensive treatment plan that addresses both the cervical pain and any residual effects from the MVD surgery. Regular follow-up and adjustments to the treatment plan may be necessary to optimize recovery and ensure the best possible outcomes for the patient.

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