BlueCross BlueShield of Tennessee Medical Policy Manual

Spinal Unloading Devices for the Treatment of Low Back Pain


The goal of traction is to separate the space between vertebral bodies to unload the spine and decompress discs, alleviate pain and support healing. Self-operated devices for lumbar spinal unloading are available for use at home and include pneumatic systems (e.g., Orthotrac Pneumatic Vest™, STx™ Saunders Lumbar Traction Device, Saunders Lumbar Hometrac™ Deluxe) and gravity-dependent devices (e.g., LTX 3000™). These devices have been investigated as conservative, non-invasive treatment options for subacute and chronic low back pain for individuals who have not responded adequately to standard medical therapy.




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


Agency for Healthcare Research and Quality. (2016, November). Noninvasive treatments for low back pain: current state of the evidence. Retrieved April 26, 2019 from

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

National Institute for Health and Care Excellence. (2016, November; last update search December 2020). Low back pain and sciatica in over 16s: assessment and management. Retrieved January 14, 2021 from

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care. Diagnosis and treatment of degenerative lumbar spinal stenosis. Retrieved January 14, 2021 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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