Zygapophyseal Joint

Publication Title: 
The Spine Journal: Official Journal of the North American Spine Society

BACKGROUND CONTEXT: Spinal manipulation (SM) is an effective treatment for low back pain (LBP), and it has been theorized that SM induces a beneficial neurophysiological effect by stimulating mechanically sensitive neurons in the lumbar facet joint capsule (FJC). PURPOSE: The purpose of this study was to determine whether human lumbar FJC strains during simulated SM were different from those that occur during physiological motions. STUDY DESIGN/SETTING: Lumbar FJC strains were measured in human cadaveric spine specimens during physiological motions and simulated SM in a laboratory setting.

Author(s): 
Ianuzzi, Allyson
Khalsa, Partap S.
Publication Title: 
Annals of Biomedical Engineering

There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude.

Author(s): 
Little, Jesse S.
Khalsa, Partap S.
Publication Title: 
Journal of Biomechanical Engineering

The human facet joint capsule is one of the structures in the lumbar spine that constrains motions of vertebrae during global spine loading (e.g., physiological flexion). Computational models of the spine have not been able to include accurate nonlinear and viscoelastic material properties, as they have not previously been measured. Capsules were tested using a uniaxial ramp-hold protocol or a haversine displacement protocol using a commercially available materials testing device. Plane strain was measured optically.

Author(s): 
Little, Jesse S.
Khalsa, Partap S.
Publication Title: 
Journal of Biomechanical Engineering

High-velocity, low-amplitude spinal manipulation (HVLA-SM) is an efficacious treatment for low back pain, although the physiological mechanisms underlying its effects remain elusive. The lumbar facet joint capsule (FJC) is innervated with mechanically sensitive neurons and it has been theorized that the neurophysiological benefits of HVLA-SM are partially induced by stimulation of FJC neurons. Biomechanical aspects of this theory have been investigated in humans while neurophysiological aspects have been investigated using cat models.

Author(s): 
Ianuzzi, Allyson
Pickar, Joel G.
Khalsa, Partap S.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

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.

Author(s): 
Cramer, Gregory D.
Ross, Kim
Pocius, Judith
Cantu, Joe A.
Laptook, Evelyn
Fergus, Michael
Gregerson, Doug
Selby, Scott
Raju, P. K.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The lumbar facet joint capsule (FJC) is innervated with mechanically sensitive neurons and is thought to contribute to proprioception and pain. Biomechanical investigations of the FJC have commonly used human cadaveric spines, whereas combined biomechanical and neurophysiological studies have typically used nonhuman animal models.

Author(s): 
Ianuzzi, Allyson
Pickar, Joel G.
Khalsa, Partap S.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVES: The purpose of this study was to use previously validated methods to quantify and relate 2 phenomena associated with chiropractic spinal manipulative therapy (SMT): (1) cavitation and (2) the simultaneous gapping (separation) of the lumbar zygapophyseal (Z) joint spaces. METHODS: This was a randomized, controlled, mechanistic clinical trial with blinding. Forty healthy participants (18-30 years old) without a history of low-back pain participated. Seven accelerometers were affixed to the skin overlying the spinous processes of L1 to L5 and the S1 and S2 sacral tubercles.

Author(s): 
Cramer, Gregory D.
Ross, Kim
Raju, P. K.
Cambron, Jerrilyn
Cantu, Joe A.
Bora, Preetam
Dexheimer, Jennifer M.
McKinnis, Ray
Habeck, Adam R.
Selby, Scott
Pocius, Judith D.
Gregerson, Douglas
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The purpose of this study was to quantify lumbar zygapophyseal (Z) joint space separation (gapping) in low back pain (LBP) subjects after spinal manipulative therapy (SMT) or side-posture positioning (SPP). METHODS: This was a controlled mechanisms trial with randomization and blinding. Acute LBP subjects (N = 112; four n = 28 magnetic resonance imaging [MRI] protocol groups) had 2 MRI appointments (initial enrollment and after 2 weeks of chiropractic treatment, receiving 2 MRI scans of the L4/L5 and L5/S1 Z joints at each MRI appointment.

Author(s): 
Cramer, Gregory D.
Cambron, Jerrilyn
Cantu, Joe A.
Dexheimer, Jennifer M.
Pocius, Judith D.
Gregerson, Douglas
Fergus, Michael
McKinnis, Ray
Grieve, Thomas J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVES: Manual therapy practitioners commonly assess lumbar intervertebral mobility before deciding treatment regimens. Changes in mechanoreceptor activity during the manipulative thrust are theorized to be an underlying mechanism of spinal manipulation (SM) efficacy. The objective of this study was to determine if facet fixation or facetectomy at a single lumbar level alters muscle spindle activity during 5 SM thrust durations in an animal model. METHODS: Spinal stiffness was determined using the slope of a force-displacement curve.

Author(s): 
Reed, William R.
Long, Cynthia R.
Pickar, Joel G.
Publication Title: 
Spine

STUDY DESIGN: A blinded, randomized controlled trial was conducted. OBJECTIVE: To test the hypothesis that chiropractic side-posture manipulation (adjusting) of the lumbar spine separates (gaps) the zygapophysial (Z) joints. SUMMARY OF BACKGROUND DATA: Spinal adjusting is thought to gap the Z joints, yet no studies have conclusively validated this hypothesis, and some investigators have reported that the lumbar Z joints do not gap during rotation.

Author(s): 
Cramer, Gregory D.
Gregerson, Douglas M.
Knudsen, J. Todd
Hubbard, Bradley B.
Ustas, Leah M.
Cantu, Joe A.

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