BlueCross BlueShield of Tennessee Medical Policy Manual

Spinal Unloading Devices for the Treatment of Low Back Pain


Patient-operated spinal unloading devices have been investigated as a conservative, non-invasive treatment option for subacute and chronic low back pain for individuals who have not responded adequately to standard medical therapy. The intent of these devices is to provide a traction-like effect by shifting weight bearing off the lower back and onto the hips. The method used to shift weight bearing varies among devices. Some devices (e.g., LTX 3000™) utilize gravitational force provided by the body mass of the individual. The LTX 3000 consists of an adjustable seat strap and rib support pads that purportedly stabilize the upper body by engaging the lowest portion of the rib cage. After the rib support pads have been properly adjusted, the individual lowers the seat strap to induce unloading of the lumbar spine via the downward force provided by the individual’s body mass.

Other devices (e.g., Orthotrac Pneumatic Vest™, STx™ Saunders Lumbar Traction Device, and Saunders Lumbar Hometrac™ Deluxe) utilize applied pneumatic pressure in an effort to shift weight bearing off the lower back.




There is insufficient evidence from peer-reviewed published studies to conclude that axial spinal unloading devices are effective in the management of low back pain.


American College of Physicians. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Retrieved July 21, 2017 from

Institute for Clinical Systems Improvement. (2012). Adult acute and subacute low back pain. Retrieved May 30, 2014 from

National Institute for Health and Care Excellence. (2016). Low back pain and sciatica in over 16s: assessment and management. Retrieved July 21, 2017 from

U. S. Food and Drug Administration. (2008, April). Center for Devices and Radiological Health. Code of Federal Regulations: Title 21: Volume 8: 21CFR888.5850: Part 888 Orthopedic Devices: Section 888.5850. Nonpowered orthopedic traction apparatus and accessories. Retrieved February 9, 2009 from




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