Force Distribution Within Spinal Tissues During Posterior to Anterior Spinal Manipulative Therapy: A Secondary Analysis.
Force Distribution Within Spinal Tissues During Posterior to Anterior Spinal Manipulative Therapy: A Secondary Analysis.
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DOI：
10.3389/fnint.2021.809372
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发表时间：
2021
影响因子：
3.5
通讯作者：
Kawchuk GN
中科院分区：
文献类型：
--
作者：
Funabashi M;Breen AC;De Carvalho D;Pagé I;Nougarou F;Descarreaux M;Kawchuk GN
先前的研究观察到，椎间盘在脊柱推拿治疗（SMT）期间经历最大的力，并且脊柱组织之间的力的分布作为SMT参数的函数而变化。然而，情境化的SMT力量，相对于应用于和经历的整个功能性脊柱单位，需要了解SMT的潜在机制。描述脊柱组织之间相对于所施加SMT力和功能单元所经受的总力的百分比力分布。该二次分析结合了来自35具新鲜猪尸体的数据，这些猪尸体通过伺服控制的线性电机致动器暴露于L3/L4小关节上方皮肤的模拟300 N SMT。使用留置骨针光学跟踪椎体运动学。然后将功能性脊柱单元取出并安装在配备有6轴测力传感器的平行机器人平台上。SMT过程中脊柱的运动学由机器人平台重放。通过使用连续解剖，记录脊柱结构在所有三个运动轴上所经历的模拟SMT引起的峰值和平均力。对脊柱结构所受的力进行了连续性分析，并计算了合力的大小。在SMT期间，功能性脊柱单元经受的中位峰值合力为36.4N（IQR：14.1N），平均合力为25.4N（IQR：11.9N）。脊柱节段承受的峰值合力相当于总SMT施加力（300 N）的12.1%。当脊柱功能单元所承受的合力被认为是100%时，棘上韧带和棘间韧带所承受的力为峰值力的0.3%和平均力的0.5%。小关节和黄韧带承受了0.7%的峰值力和3%的平均力。椎间盘和纵韧带承受了99%的峰值力和96.5%的平均力。在该动物模型中，在从后向前SMT期间施加的力的一小部分到达腰椎中的脊柱结构。大多数SMT力（超过96%）由椎间盘承受。这项研究提供了一个新的角度SMT力分布在脊柱组织。
Previous studies observed that the intervertebral disc experiences the greatest forces during spinal manipulative therapy (SMT) and that the distribution of forces among spinal tissues changes as a function of the SMT parameters. However, contextualized SMT forces, relative to the ones applied to and experienced by the whole functional spinal unit, is needed to understand SMT’s underlying mechanisms. To describe the percentage force distribution between spinal tissues relative to the applied SMT forces and total force experienced by the functional unit. This secondary analysis combined data from 35 fresh porcine cadavers exposed to a simulated 300N SMT to the skin overlying the L3/L4 facet joint via servo-controlled linear motor actuator. Vertebral kinematics were tracked optically using indwelling bone pins. The functional spinal unit was then removed and mounted on a parallel robotic platform equipped with a 6-axis load cell. The kinematics of the spine during SMT were replayed by the robotic platform. By using serial dissection, peak and mean forces induced by the simulated SMT experienced by spinal structures in all three axes of motion were recorded. Forces experienced by spinal structures were analyzed descriptively and the resultant force magnitude was calculated. During SMT, the functional spinal unit experienced a median peak resultant force of 36.4N (IQR: 14.1N) and a mean resultant force of 25.4N (IQR: 11.9N). Peak resultant force experienced by the spinal segment corresponded to 12.1% of the total applied SMT force (300N). When the resultant force experienced by the functional spinal unit was considered to be 100%, the supra and interspinous ligaments experienced 0.3% of the peak forces and 0.5% of the mean forces. Facet joints and ligamentum flavum experienced 0.7% of the peak forces and 3% of the mean forces. Intervertebral disc and longitudinal ligaments experienced 99% of the peak and 96.5% of the mean forces. In this animal model, a small percentage of the forces applied during a posterior-to-anterior SMT reached spinal structures in the lumbar spine. Most SMT forces (over 96%) are experienced by the intervertebral disc. This study provides a novel perspective on SMT force distribution within spinal tissues.
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影响因子：
1.8
作者：
Colloca, CJ;Keller, TS;Harrison, DD
通讯作者：
Harrison, DD
影响因子：
2.4
作者：
Funabashi, Martha;El-Rich, Marwan;Kawchuk, Gregory N.
通讯作者：
Kawchuk, Gregory N.
影响因子：
3
作者：
Gillespie, KA;Dickey, JP
通讯作者：
Dickey, JP
影响因子：
4.5
作者：
Funabashi, Martha;Nougarou, Francois;Kawchuk, Gregory N.
通讯作者：
Kawchuk, Gregory N.
DOI：
10.1016/j.jmpt.2003.11.021
发表时间：
2004-01-01
影响因子：
1.3
作者：
Colloca, CJ;Keller, TS;Gunzburg, R
通讯作者：
Gunzburg, R