Cox® Technic Flexion Distraction is gentle, safe spinal manipulation for spondylolisthesis pain relief. Spondylolisthesis is a demanding condition of the physician and the patient. Spondylolisthesis may cause pain down the leg and even into the foot, not just in the back. Treatment feels great to the patient who may even ask for "more," but the doctor has to remain vigilant in following the principle that "less is more" when treating the spondylolisthesis patient. Flexion distraction is most effective with stable spondylolisthesis. Granted, the spondylolisthesis patient must also learn to put parameters around his or her movements to prevent pain, but relief may be possible with the right non-surgical care.
Spondylolisthesis patients can consider these articles, then contact a certified physician for treatment and relief of spondylolisthesis symptoms.
Dunn AS, Baylis S, Ryan D. Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report. J Chiropr Med 2009 Sep;8(3):125-30
  • A United States Marine veteran treated with flexion distraction at a VA hospital for multilevel spondylolisthesis found relief in 10 visits in 8 weeks. This treatment is recommended as possible form of care for this condition.
  • The 43-year-old patient had a 20-year history of mechanical back pain secondary to an injury sustained during active military duty. He had intermittent radiation of numbness and tingling involving the right lower extremity distal to the knee.

Cox JM, Trier K: Chiropractic adjustment results correlated with spondylolisthesis instability. J of Manual Medicine 1991;6:67-72
  • Stable Spondylolisthesis 75% Relieved of Pain with Cox® Distraction


Cox JM, Trier K: Chiropractic adjustment results correlated with spondylolisthesis instability. Journal of Manipulative and Physiological Therapeutics 1991;6:67-72

  • Ten true spondylolisthesis patients, nine with the lesion at L5 and one at L3, were tested by vertical suspension radiography compared to neutral lateral weight-bearing x-ray to determine translational segmental instability. Cases were classed as unstable (high instability) if over 3 mm of translation of the spondylolisthetic segment occurred and as stable (low instability) if less than 3 mm of motion was seen. Chiropractic distraction adjustment was applied in each case, and the response to care was evaluated by subjective rating of pain relief. Results found that all five patients with stable spondylolisthesis cases obtained 75% or greater relief from chiropractic adjustment of  the type used by the author, whereas one with the unstable variety experienced over 75% relief while the other four had less than 50% relief of pain. As defined in this paper, stable true spondylolisthesis seems to respond better than the unstable variety.


Cox JM, Aspegren DC: Degenerative spondylolisthesis of C7 and L4 in same patient. Journal of Manipulative and Physiological Therapeutics 1988;11(3):195-205

  • The incidence of a C7 spondylolisthesis has never been reported, and this paper shows the presence of C7 and L4 degenerative spondylolisthesis in a a 66-yr-old female; no report of this combined problem has been reported. The clinical findings of the patient are given as well as treatment protocol. In clinical practice, the finding of degenerative spondylolisthesis should be understood as being best handled conservatively, as it rarely causes neurological deficit nor requires surgery.


Cox JM, Wright J: Unstable spondylolisthesis. DC Tracts 1(6): 357-368 (December 1989)


For a complete list of publications on Cox® Technic, click here.