Cooper Kay, Alexander Lyndsay, Hancock Elizabeth, Smith Francis W
School of Health Sciences, Robert Gordon University, Garthdee Road, Aberdeen AB10 7QG, UK.
Man Ther. 2013 Aug;18(4):289-93. doi: 10.1016/j.math.2012.10.005. Epub 2012 Nov 4.
Accurate palpation of lumbar spinous processes (SPs) is a key component of spinal assessment. It is also vital for the accurate measurement of spinal motion when using external skin marker-based measurement systems, which are being increasingly used to understand low back disorders and their management. The aim was to assess the accuracy of lumbar spinous process (SP) palpation using positional magnetic resonance imagery (MRI) (pMRI). Two experienced manual therapists palpated the L4 SP of nine pain-free participants in standing and prone lying. For each position, an MRI marker was attached over the SP and pMRI scanning was conducted. The position of the marker in relation to L4 on the MRI images was visually inspected, and measurements (mm) of the vertical distance from the superior/inferior aspect of the marker to the superior/inferior aspect of the L4 SP were used to determine palpation accuracy. 71% of Markers were correctly placed over the L4 SP. The magnitude of error for incorrectly placed markers was small, with the largest median distance of 2.7 mm (interquartile range (IQR) 0-3.6) recorded for one of the therapists palpating in prone lying. 100% of markers were correctly placed either on L4 or within one SP in height. pMRI is useful for investigating the accuracy of SP palpation in positions relevant to clinical and research practice.
准确触诊腰椎棘突（SPs）是脊柱评估的关键组成部分。在使用基于皮肤外部标记的测量系统时，准确触诊对于精确测量脊柱运动也至关重要，这类系统正越来越多地用于了解下背部疾病及其治疗。本研究旨在使用定位磁共振成像（pMRI）评估腰椎棘突（SP）触诊的准确性。两名经验丰富的手法治疗师对9名无疼痛的参与者在站立位和俯卧位时的L4棘突进行了触诊。对于每个体位，在棘突上方附着一个MRI标记并进行pMRI扫描。目视检查MRI图像上标记相对于L4的位置，并使用从标记的上/下边缘到L4棘突上/下边缘的垂直距离测量值（mm）来确定触诊准确性。71%的标记被正确放置在L4棘突上方。放置错误的标记误差幅度较小，其中一名治疗师在俯卧位触诊时记录到的最大中位数距离为2.7 mm（四分位间距（IQR）0 - 3.6）。100%的标记被正确放置在L4上或在高度上相差一个棘突范围内。pMRI对于研究与临床和研究实践相关体位下棘突触诊准确性很有用。
