Colloca Christopher J, Gunzburg Robert, Freeman Brian J, Szpalski Marek, Afifi Mostafa, Moore Robert J
School of Nutrition and Health Promotion, Arizona State University, Tempe, AZ, USA.
J Manipulative Physiol Ther. 2012 Jun;35(5):354-66. doi: 10.1016/j.jmpt.2012.04.018. Epub 2012 May 30.
The purposes of this study were to quantify the biomechanical and pathologic consequences of surgically induced spinal lesions and to determine their response to spinal manipulation (SMT) in an in vivo ovine model.
Of 24 Merino sheep, 6 received L5 spondylolytic defects, 6 received L1 annular lesions, and 12 served as respective controls. Dorsoventral (DV) stiffness was assessed using oscillatory loads (2-12 Hz). Two SMT force-time profiles were administered in each of the groups using a randomized and repeated-measures design. Stiffness and the effect of SMT on the DV motions and multifidus needle electromyographic responses were assessed using a repeated-measures analysis of variance (α = .05). Postmortem histologic analysis and computed tomography validated the presence of lesions.
L5 DV stiffness was significantly increased (40.2%) in the spondylolysis (6.28 N/mm) compared with the L5 control group (4.48 N/mm) (P < 03). Spinal manipulations delivered to the spondylolysis group resulted in less DV vertebral displacement (P < .01) compared with controls. Dorsoventral stiffness of the disc degeneration group was 5.66 N/mm, 94.5% greater than in the L1 control group (2.91 N/mm) (P < .01). One hundred-millisecond SMTs resulted in significantly reduced DV displacements in the disc degeneration group compared with the L1 control group (P < .01). Animals in the disc degeneration group showed a consistent 25% to 30% reduction in needle electromyographic responses to all SMTs.
Quantifiable objective evidence of spinal lesions and their response to SMT were confirmed in this study. Neuromechanical alterations provide novel insights into quantifying manipulable spinal lesions and a means to biomechanically assess SMT outcomes.
本研究旨在量化手术诱导的脊柱病变的生物力学和病理学后果，并确定其在体内绵羊模型中对脊柱推拿（SMT）的反应。
24只美利奴绵羊中，6只接受L5峡部裂缺损，6只接受L1椎间盘损伤，12只作为各自的对照组。使用振荡负荷（2 - 12赫兹）评估背腹（DV）刚度。采用随机重复测量设计，对每组施加两种SMT力 - 时间曲线。使用重复测量方差分析（α = 0.05）评估刚度以及SMT对DV运动和多裂肌针电极肌电图反应的影响。死后组织学分析和计算机断层扫描验证了病变的存在。
与L5对照组（4.48 N/mm）相比，峡部裂组的L5 DV刚度显著增加（40.2%）（6.28 N/mm）（P < 0.03）。与对照组相比，对峡部裂组进行脊柱推拿导致的DV椎体位移较小（P < 0.01）。椎间盘退变组的背腹刚度为5.66 N/mm，比L1对照组（2.91 N/mm）高94.5%（P < 0.01）。与L1对照组相比，100毫秒的SMT导致椎间盘退变组的DV位移显著减少（P < 0.01）。椎间盘退变组的动物对所有SMT的针电极肌电图反应一致降低25%至30%。
本研究证实了脊柱病变及其对SMT反应的可量化客观证据。神经力学改变为量化可推拿的脊柱病变提供了新的见解，并为生物力学评估SMT结果提供了一种方法。
