Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, USA.
Evid Based Complement Alternat Med. 2013;2013:954134. doi: 10.1155/2013/954134. Epub 2013 Aug 20.
The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.
本研究的目的是测量在手动颈椎牵引（MCD）过程中颈椎下部椎间盘内压力（IDP）的变化。在前部做切口，并将压力传感器插入每个下位颈椎的核内。四名熟练的脊医（DC）在俯卧位下对 9 个标本进行 MCD 操作，头架接触 C5 或 C6 椎体，处于不同位置。使用描述性统计分析 IDP 变化、牵引力和手动施加的前后向力。在所有下位颈椎 C4-C5、C5-C6 和 C6-C7 水平，MCD 过程中均观察到 IDP 降低。平均 IDP 降低高达 168.7kPa。平均牵引力高达 119.2N。手动牵引时施加的前后向力高达 82.6N。对于所有 4 名 DC，IDP 降低的临床医生内可靠性都很高。虽然有两名 DC 对应用的牵引力具有较高的临床医生内可靠性，但另外两名 DC 仅显示出中度可靠性。在活动性屈伸和牵引过程中，IDP 降低最大。随着中性牵引、固定性屈伸牵引和广泛性牵引，其降低程度逐渐降低。
