Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study.

Publisher: Elsevier Inc Country of Publication: United States NLM ID: 7807107 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6586 (Electronic) Linking ISSN: 01614754 NLM ISO Abbreviation: J Manipulative Physiol Ther Subsets: MEDLINE

Publication: New York, NY : Elsevier Inc.
Original Publication: Lombard, Ill., National College of Chiropractic.

Manipulation, Spinal* ; Torsion, Mechanical*; Intervertebral Disc/*diagnostic imaging ; Low Back Pain/*physiopathology ; Lumbar Vertebrae/*diagnostic imaging; Adult ; Biomechanical Phenomena ; Chronic Pain/diagnostic imaging ; Chronic Pain/physiopathology ; Humans ; Imaging, Three-Dimensional ; Intervertebral Disc/physiology ; Intervertebral Disc/physiopathology ; Low Back Pain/diagnostic imaging ; Lumbar Vertebrae/physiology ; Lumbar Vertebrae/physiopathology ; Middle Aged ; Posture/physiology ; Rotation ; Tomography, X-Ray Computed ; Young Adult

Objectives: Axial rotation of the torso is commonly used during manipulation treatment of low back pain. Little is known about the effect of these positions on disc morphology. Rotation is a three-dimensional event that is inadequately represented with planar images in the clinic. True quantification of the intervertebral gap can be achieved with a disc height distribution. The objective of this study was to analyze disc height distribution patterns during torsion relevant to manipulation in vivo.
Methods: Eighty-one volunteers were computed tomography-scanned both in supine and in right 50° rotation positions. Virtual models of each intervertebral gap representing the disc were created with the inferior endplate of each "disc" set as the reference surface and separated into 5 anatomical zones: 4 peripheral and 1 central, corresponding to the footprint of the annulus fibrosus and nucleus pulposus, respectively. Whole-disc and individual anatomical zone disc height distributions were calculated in both positions and were compared against each other with analysis of variance, with significance set at P < .05.
Results: Mean neutral disc height was 7.32 mm (1.59 mm). With 50° rotation, a small but significant increase to 7.44 mm (1.52 mm) (P < .0002) was observed. The right side showed larger separation in most levels, except at L5/S1. The posterior and right zones increased in height upon axial rotation of the spine (P < .0001), whereas the left, anterior, and central decreased.
Conclusions: This study quantified important tensile/compressive changes disc height during torsion. The implications of these mutually opposing changes on spinal manipulation are still unknown.
(Copyright © 2016 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.)

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P01 AR048152 United States AR NIAMS NIH HHS; R01 AT006692 United States AT NCCIH NIH HHS

Keywords: Computed Tomography; Imaging; Intervertebral Disc; Mechanical; Spinal Manipulation; Three-Dimensional; Torsion

Date Created: 20160410 Date Completed: 20180404 Latest Revision: 20181113

20231215

PMC4864143

10.1016/j.jmpt.2016.03.002

27059249