Neuromechanical characterization of in vivo lumbar spinal manipulation. Part II. Neurophysiological response.

摘要: Abstract Objective To simultaneously quantify vertebral motions and neuromuscular spinal nerve root responses to mechanical force, manually assisted, short-lever manipulative thrusts. Methods Four patients underwent lumbar laminarthrectomy decompress the central canal neuroforamina, as clinically indicated. Prior decompression, finely threaded, 1.8-mm diameter intraosseous pins were rigidly fixed spinous process (L1 or L3) using fluoroscopic guidance, a high-frequency, low-noise, 10-g, triaxial accelerometer was mounted pin. Following 4 needle electromyographic (nEMG) electrodes inserted into multifidus musculature adjacent pin mount bilaterally, 2 bipolar platinum cradled around left right S1 roots. With spine exposed, thrusts delivered internally lumbosacral processes facet joints externally by contacting skin overlying respective landmarks force settings (≈ 30 N, Results Spinal resulted in positive (EMG) compound action potential (CAP) that typically characterized single voltage change lasting several milliseconds duration. However, multiple EMG CAP discharges observed numerous cases. The temporal relationship between initiation of thrust neurophysiologic response internal external therapy (SMT) ranged from 2.4 18.1 ms 28.6 for responses, respectively. Neurophysiologic varied substantially patients. Conclusions Vertebral resulting reflex appear be temporally related applied during SMT. These findings suggest intersegmental produced manipulation may play prominent role eliciting physiologic responses.