Doctor of Physical Therapy (DPT) program, School of Health Sciences, Oakland University, IN, USA.
Division of Healthcare Simulation Science, Department of Surger, University of Washington, Seattle, USA.
J Man Manip Ther. 2023 Apr;31(2):93-97. doi: 10.1080/10669817.2022.2077604. Epub 2022 May 23.
Some manual therapy schools of thought rely on palpation of vertebral position via bony processes prior to the application of directional manual interventions. It is feasible that malformation or asymmetry of the spinous processes (SPs) or transverse processes (TPs), if unknown, may influence the outcome of a diagnostic palpatory exam and the application of directional manual interventions. This study provides morphometric data for the lumbar spine, to assess the occurrence of length differences in lumbar SPs and TPs occurring between the right and left sides.
The lumbar processes were measured bilaterally in 16 adult cadaveric specimens, 9 females and 7 males ranging in age from 68 to 89 years. A measurable difference in SP length, defined as ≥ 0.1 cm, was found in 72.4% of the population, and for TP lengthin 90.6% of the population. A mean SP length difference of 0.2 ± 0.2 cm and a mean TP length difference of 0.4 ± 0.3 cm were observed. Process length was longer on average for males, and the magnitude of process length difference increased with age.
These results indicate that a finding of a clinical positional fault of a vertebra through palpatory exam may be flawed.
一些手动治疗学派依靠触诊棘突位置的骨性突起，然后再进行定向手动干预。如果不知道棘突（SPs）或横突（TPs）的畸形或不对称，可能会影响诊断触诊检查的结果和定向手动干预的应用。本研究提供了腰椎的形态计量学数据，以评估腰椎 SP 和 TP 左右两侧长度差异的发生情况。
在 16 具成人尸体标本中，对双侧的腰椎棘突进行了测量，年龄在 68 至 89 岁之间，有 9 名女性和 7 名男性。在 72.4%的人群中发现 SP 长度有可测量的差异（定义为≥0.1cm），在 90.6%的人群中发现 TP 长度有可测量的差异。SP 长度的平均差异为 0.2 ± 0.2cm，TP 长度的平均差异为 0.4 ± 0.3cm。男性的平均棘突长度较长，并且棘突长度差异的幅度随年龄增长而增加。
这些结果表明，通过触诊检查发现的一个椎体的临床位置性错误可能是有缺陷的。
