Abstract
Objective
This project determined the feasibility of conducting larger studies assessing the
relationship between cavitation and zygapophyseal (Z) joint gapping following spinal
manipulative therapy (SMT).
Methods
Five healthy volunteers (average age, 25.4 years) were screened and examined against
inclusion and exclusion criteria. High-signal magnetic resonance imaging (MRI) markers
were fixed to T12, L3, and S1 spinous processes. Scout images were taken to verify
the location of the markers. Axial images of the L4/L5 and L5/S1 levels were obtained
in the neutral supine position. Following the first MRI, accelerometers were placed
over the same spinous processes; and recordings were made from them during side-posture
positioning and SMT. The accelerometers were removed, and each subject was scanned
in side-posture. The greatest central anterior to posterior Z joint spaces (gap) were
measured from the first and second MRI scans. Values obtained from the first scan
were subtracted from those of the second, with a positive result indicating an increase
in gapping following SMT (positive gapping difference). Gapping difference was compared
between the up-side (SMT) joints vs the down-side (non-SMT) joints and between up-side
cavitation vs up-side noncavitation joints.
Results
Greater gapping was found in Z joints that received SMT (0.5 ± 0.6 mm) vs non-SMT
joints (−0.2 ± 0.6 mm), and vertebral segments that cavitated gapped more than those
that did not cavitate (0.8 ± 0.7 vs 0.4 ± 0.5 mm).
Conclusions
A future clinical study is quite feasible. Forty subjects (30 in an SMT group and
10 in a control group) would be needed for appropriate power (0.90).
Key Indexing Terms
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Article info
Publication history
Accepted:
October 27,
2010
Received in revised form:
September 25,
2010
Received:
August 6,
2010
Identification
Copyright
© 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
