Abstract
Background: Spinal manipulation therapy is used by millions of patients each year to relieve
symptoms caused by biomechanical dysfunction of the spine. Cerebrovascular accidents
in the posterior cerebral circulation are a feared complication, but little research
has been done on vertebral artery hemodynamics during cervical manipulation. Objective: The purpose of this study was to develop an experimental model for investigations
of volume blood flow changes in the vertebral arteries during premanipulative testing
of these vessels and during spinal manipulation therapy of the cervical spine. Design and Setting: An experimental study in a university biomedical laboratory. Material and Methods: The vertebral arteries were exposed in 8 adult pigs after extensive mediastinal dissection.
Volume blood flow was measured on both sides simultaneously by advanced transit-time
flowmetry. Results: After cervical manipulation, the vertebral artery volume blood flow increased significantly
for 40 seconds before returning to baseline values in less than 3 minutes. We found
no significant changes in volume blood flow during premanipulative testing of the
vertebral arteries (DeKleyn's test). Conclusion: We present an experimental model for investigations of vertebral artery hemodynamics
during biomechanical interventions. We found a modest and transient effect of cervical
manipulation on vertebral artery volume flow. The model may have further applications
in future biomechanical research, for example, to determine whether any of several
spinal manipulative techniques imposes less strain on the vertebral artery, thereby
reducing possible future cerebrovascular accidents after such treatment. (J Manipulative
Physiol Ther 1999; 22:431–5)
Keywords
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Article info
Publication history
Received:
November 25,
1998
Footnotes
☆Submit reprint requests to: Peter B. Licht, MD, Department of Clinical Physiology and Nuclear Medicine, Odense University Hospital, Sønder Boulevard 29, DK-5000 Odense, Denmark.
Identification
Copyright
© 1999 JMPT. Published by Elsevier Inc. All rights reserved.
