Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Musculoskelet Sci Pract. 2018 Apr;34:97-102. doi: 10.1016/j.msksp.2018.01.007. Epub 2018 Feb 6.
Cervical foraminal impingement has been described as a source of radicular pain. Clinical tests and head motions have been reported for affecting the intervertebral foramen (IVF) dimensions. Although manual approaches are proposed in the management of cervical radiculopathy, their influence on the foraminal dimensions remains unclear.
To investigate the influence of pre-manipulative positioning versus cervical axial rotation on the foraminal dimensions of the lower cervical spine.
Thirty asymptomatic volunteers underwent CT scan imaging in neutral position and axial rotation or pre-manipulative positioning. The manipulation task was performed at C4-C5 following a multiple components procedure. 3D kinematics and IVF (height, width and area) were computed for each cervical segment.
The results showed that foraminal changes are dependent on motion types and cervical levels. With reference to head rotation, IVF opening occurred on the ipsilateral side during pre-manipulative positioning while axial rotation involved the contralateral side. Regardless of the side considered, magnitudes of opening were similar between both attitudes while narrowing was lower at the target and adjacent levels during the pre-manipulative positioning. Some associations between segmental motion and IVF changes were observed for the target level and the overlying level.
The present study demonstrated that pre-manipulative positioning targeting C4-C5 modified IVF dimensions differently than the passive axial rotation. The findings suggest that techniques which incorporate combined movement positioning influence segmental motion and IVF dimensions differently at the target segment, compared to unconstrained rotation. Further investigations are needed to determine the clinical outcomes of such an approach.
颈椎椎间孔狭窄已被描述为神经根痛的一个来源。临床检查和头部运动已被报道会影响椎间孔（IVF）的尺寸。虽然在管理颈椎神经根病时提出了手动方法，但它们对椎间孔尺寸的影响仍不清楚。
研究预操作定位与颈椎轴向旋转对下颈椎椎间孔尺寸的影响。
30 名无症状志愿者在中立位和轴向旋转或预操作定位下进行 CT 扫描成像。在 C4-C5 处按照多组件程序进行操作任务。为每个颈椎节段计算 3D 运动学和 IVF（高度、宽度和面积）。
结果表明，椎间孔变化取决于运动类型和颈椎水平。与头部旋转相比，在预操作定位时，同侧的椎间孔打开，而轴向旋转则涉及对侧。无论考虑哪一侧，两种体位的开口幅度相似，而在预操作定位时，目标和相邻节段的变窄程度较低。在目标水平和上覆水平观察到节段运动与 IVF 变化之间的一些关联。
本研究表明，针对 C4-C5 的预操作定位与被动轴向旋转不同，会改变 IVF 尺寸。研究结果表明，与不受约束的旋转相比，包含组合运动定位的技术会对目标节段的节段运动和 IVF 尺寸产生不同的影响。需要进一步研究以确定这种方法的临床效果。
