Variability of Intradiscal Pressure During Cervical Spine Posterior-Anterior Mobilization: A Cadaveric Investigation

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Carla M. James PT, ScD , Jean-Michel Brismée PT, ScD , Marc-Olivier St-Pierre PhD , Martin Descarreaux DC, PhD , Troy L. Hooper PT, LAT, ATC, PhD , François Nougarou PhD , Emile Marineau Bélanger DC , Stéphane Sobczak PT, PhD
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Abstract

Objectives

The purpose of this study was to investigate in cadaveric specimens the reliability of measuring cervical intradiscal pressure (CIDP) and if posterior-anterior (PA) mobilizations targeting the cervical spine were associated with CIDP changes.

Methods

Cervical PA mobilizations were performed on the spinous processes of 7 (3 men, 4 women) cadaveric specimens using a servo-controlled linear actuator to provide 25N and 45N forces. CIDP measurements were performed at C4-5, C5-6, C6-7, and C7-T1 intervertebral discs (IVDs) using a fiberoptic catheter system that recorded CIDP for each IVD cervical segment. To assess CIDP measurement reliability, the intraclass correlation coefficient (ICC [3,k]) was calculated. Repeated measures Friedman analysis of variance assessed effect of cervical mobilizations on CIDP for before, during, and immediately after mobilization at 25N and 45N forces for each cervical IVD segment.

Results

All CIDP measurements demonstrated excellent reliability (ICC >0.98). During the 25N mobilizations, the median CIDP varied from -0.12 to 0.91 (interquartile range, 5.22-5.36), while for 45N mobilizations the median ranged from -0.94 to 1.21 (interquartile range, -7.74 to 43.49). These changes were not statistically significant (P > .40) during 25N and 45N PA mobilizations, with the exception of C5-6 CIDP at 25N and 45N (P = .05 and .018, respectively).

Conclusion

There was high CIDP variability between cadavers during and after mobilization. Mobilizations of 1 cervical vertebra resulted in both CIDP increase or decrease at adjacent and remote cervical IVD segments that were not consistent. Cervical PA mobilizations produced variable CIDP changes at adjacent and remote cervical segments in cadavers.

颈椎前后移位过程中椎间盘内压力的变异性:一项尸体调查
目的本研究的目的是探讨在尸体标本中测量颈椎椎间盘内压(CIDP)的可靠性,以及针对颈椎的后前路(PA)活动是否与CIDP变化有关。方法采用伺服控制线性致动器对7例(男3例,女4例)尸体棘突进行颈椎PA动员,施加25N和45N力。使用光纤导管系统测量C4-5、C5-6、C6-7和C7-T1椎间盘(IVD)的CIDP,记录每个IVD颈椎段的CIDP。为了评估CIDP测量的可靠性,我们计算了类内相关系数(ICC [3,k])。重复测量弗里德曼方差分析评估了在每个IVD节段以25N和45N的力动员前、期间和之后,颈椎动员对CIDP的影响。结果所有CIDP测量值具有良好的信度(ICC >0.98)。在25N的动员过程中,CIDP的中位数从-0.12到0.91(四分位数范围为5.22-5.36),而在45N的动员过程中,CIDP的中位数从-0.94到1.21(四分位数范围为-7.74到43.49)。这些变化没有统计学意义(P >在25N和45N PA动员期间,C5-6 cbp在25N和45N动员期间(P分别= 0.05和0.018),P值为0.40)。结论尸体在活动期间和活动后的CIDP差异较大。1个颈椎的活动导致相邻和远端颈椎IVD节段的CIDP升高或降低,但不一致。颈椎PA动员在尸体的邻近和远端颈椎节段产生可变的CIDP变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.00
自引率
7.70%
发文量
63
审稿时长
29 weeks
期刊介绍: The Journal of Manipulative and Physiological Therapeutics (JMPT) is an international and interdisciplinary journal dedicated to the advancement of conservative health care principles and practices. The JMPT is the premier biomedical publication in the chiropractic profession and publishes peer reviewed, research articles and the Journal''s editorial board includes leading researchers from around the world. The Journal publishes original primary research and review articles of the highest quality in relevant topic areas. The JMPT addresses practitioners and researchers needs by adding to their clinical and basic science knowledge and by informing them about relevant issues that influence health care practices.
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