Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (17): 2546-2554.doi: 10.3969/j.issn.2095-4344.2016.17.016

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Conduction characteristics of human lumbar facet joint pressures during simulated spinal manipulation versus spinal mobilization

Zhang Jun1, Wang Fei2, Liu Qiang1, Zhang Hui3, Sun Pei-dong4, Liang Dong-zhu4, Zhao Ping2   

  1. 1Department of Sinew Injury Manual Therapy Research, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China; 2Department of TCM Manipulative Orthopedics, Air Force General Hospital of Chinese PLA, Beijing 100142, China; 3Department of Rehabilitation Medicine, Beijing DCN Orthopedic Hospital, Beijing 100143, China; 4Department of Human Anatomy, Southern Medical University, Guangzhou 510515, Guangdong Province, China
  • Received:2016-03-09 Online:2016-04-22 Published:2016-04-22
  • Contact: Wang Fei, Studying for doctorate, Attending physician, Department of TCM Manipulative Orthopedics, Air Force General Hospital of Chinese PLA, Beijing 100142, China
  • About author:Zhang Jun, M.D., Chief physician, Department of Sinew Injury Manual Therapy Research, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81373657

Abstract:

BACKGROUND: The aim of spinal mobilization and spinal manipulation is to correct vertebral subluxation. However, facet joint pressures are not clear during these two therapies.   

OBJECTIVE: To compare human lumbar facet joint pressures during simulated high-velocity, low-amplitude spinal manipulation versus low-velocity, low-amplitude spinal mobilization.
METHODS: Totally 12 adult fresh lumbar spinal specimens (T12-S2) were divided into two groups randomly. Parameters of simulated spinal mobilization (n=6): preload angle 15° (speed 3°/s), maximum angle 20° (speed 1°/s), with 9 N horizontal force to L5 spinous process. Parameters of simulated spinal manipulation (n=6): preload angle 15° (speed 3°/s), impulse angle 20° (impulse speed 33°/s), with 22 N horizontal force to L5 spinous process. Pressures of bilateral L4-5/L5-S1 facet joints were measured with Tekscan system. 
RESULTS AND CONCLUSION: (1) During two spinal manipulative therapies (rotation to the right and then back to the neutral position), pressures of right facet joints decreased first and then increased gradually, while pressures of left facet joints changed oppositely. (2) Pressures of right facet joints were similar regardless of manipulation type (P > 0.05). The maximum pressure of left facet joints was larger during manipulation than that during mobilization (P < 0.05). (3) Descending speed of pressures of right joint was larger during manipulation than that during mobilization (P < 0.01), and no significant difference in ascending speed of pressure of right facet joints was detected (P > 0.05). Both ascending and descending speeds of the left facet joints were larger during manipulation than that during mobilization  (P < 0.01). (4) During two spinal manipulative therapies, pressures of ipsilateral facet joints decreased first and then increased, while pressures of contralateral facet joints increased first and then decreased. Joint pressure after treatment restored to that before treatment. (5) Impulse speed and magnitude of pressures of facet joints during manipulation were larger than that during mobilization. Facet joints are more possible to be injured during manipulation than that during mobilization. During manipulation, we should pay attention to the speed and intensity of the impact. 
中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

Key words: Lumbar Vertebrae, Manipulation, Orthopedic, Pressure, Tissue Engineering