Biomechanical and neurophysiological responses to spinal manipulation in patients with lumbar radiculopathy
Language: 
English
Abstract: 

OBJECTIVE: The purpose of this study was to quantify in vivo vertebral motions and neurophysiological responses during spinal manipulation. METHODS: Nine patients undergoing lumbar decompression surgery participated in this study. Spinal manipulative thrusts (SMTs) ( approximately 5 ms; 30 N [Sham], 88 N, 117 N, and 150 N [max]) were administered to lumbar spine facet joints (FJs) and spinous processes (SPs) adjacent to an intraosseous pin with an attached triaxial accelerometer and bipolar electrodes cradled around the S1 spinal nerve roots. Peak baseline amplitude compound action potential (CAP) response and peak-peak amplitude axial (AX), posterior-anterior (PA), and medial-lateral (ML) acceleration time and displacement time responses were computed for each SMT. Within-subject statistical analyses of the effects of contact point and force magnitude on vertebral displacements and CAP responses were performed. RESULTS: SMTs (>/= 88 N) resulted in significantly greater peak-to-peak ML, PA, and AX vertebral displacements compared with sham thrusts (P <.002). SMTs delivered to the FJs resulted in approximately 3-fold greater ML motions compared with SPs (P <.001). SMTs over the SPs resulted in significantly greater AX displacements compared with SMTs applied to the FJs (P <.05). Seventy-five percent of SMTs resulted in positive CAP responses with a mean latency of 12.0 ms. Collectively, the magnitude of the CAP responses was significantly greater for max setting SMTs compared with sham (P <.01). CONCLUSIONS: Impulsive SMTs in human subjects were found to stimulate spinal nerve root responses that were temporally related to the onset of vertebral motion. Further work, including examination of the frequency and force duration dependency of SMT, is necessary to elucidate the clinical relevance of enhanced or absent CAP responses in patients.

Author(s): 
Colloca, Christopher J.
Keller, Tony S.
Gunzburg, Robert
Item Type: 
Journal Article
Publication Title: 
Journal of Manipulative and Physiological Therapeutics
Journal Abbreviation: 
J Manipulative Physiol Ther
Publication Date: 
Jan 2004
Publication Year: 
2004
Pages: 
1-15
Volume: 
27
Issue: 
1
ISSN: 
0161-4754
DOI: 
10.1016/j.jmpt.2003.11.021
Library Catalog: 
NCBI Published Medical (?)
Extra: 
PMID: 14739869

Turabian/Chicago Citation

Christopher J. Colloca, Tony S. Keller and Robert Gunzburg. Jan 2004. "Biomechanical and neurophysiological responses to spinal manipulation in patients with lumbar radiculopathy." Journal of Manipulative and Physiological Therapeutics 27: 1: 1-15. 10.1016/j.jmpt.2003.11.021.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1016/j.jmpt.2003.11.021 | issn = 0161-4754 | volume = 27 | pages = 1-15 | last = Colloca | first = Christopher J. | coauthors = Keller, Tony S., Gunzburg, Robert | title = Biomechanical and neurophysiological responses to spinal manipulation in patients with lumbar radiculopathy | journal = Journal of Manipulative and Physiological Therapeutics | date = Jan 2004 | pmid = | pmc = }} </ref>