Abstract
Background
Extreme rotation of the cervical spine may cause compromised vertebral artery (VA)
blood flow. This is of particular interest to manual therapists because of the potential
risks associated with these movements. The question is whether the decreased blood
flow is significant and therefore likely to cause vertebrobasilar insufficiency/ischemia
(VBI) and whether contralateral and ipsilateral rotations are equally affected. Several
studies measuring VA blood flow have been reported. However, different parts of the
VA were studied, in small samples of normal subjects and patients over a wide range
of ages. Hence, the results are controversial.
Objective
To investigate intracranial VA blood flow in normal male subjects and female subjects,
aged 20 to 30 years, in neutral and maximally rotated cervical spinal positions.
Methods
Transcranial Doppler sonography was used to measure intracranial VA blood flow, with
the cervical spine in neutral and then rotated maximally to the left and later to
the right. The sample consisted of 60 male subjects and 60 female subjects (240 VAs).
Comparisons between the neutral and rotated head positions were made within and between
the groups.
Results
There was a significant decrease (P = .001) in intracranial VA blood flow following cervical spine rotation, irrespective
of side but greater on the contralateral side, in the total sample and in male subjects.
Female subjects had a significantly higher blood flow than male subjects, and although
they showed a significant decrease with contralateral rotation, there was no significant
difference in blood flow on the ipsilateral side.
Conclusion
Maximal rotation of the cervical spine may significantly affect vertebral artery blood
flow, particularly when used in the treatment of patients with underlying vascular
pathology.
Keywords
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Article info
Publication history
Received:
May 3,
2002
Footnotes
☆This work was carried out in the Department of Neurology and was partly supported by a grant from the Medical Faculty Endowment Research Fund, University of the Witwatersrand, Johannesburg, South Africa.
Identification
Copyright
© 2003 JMPT. Published by Elsevier Inc. All rights reserved.
