Abstract
BackgroundLittle information is available concerning the biomechanism involved in the spinal cord injury after cervical rotatory manipulation (CRM). The primary purpose of this study was to explore the biomechanical and kinematic effects of CRM on a healthy spinal cord.MethodsA finite element (FE) model of the basilaris cranii, C1–C7 vertebral bodies, nerve root complex and vertebral canal contents was constructed and validated against in vivo and in vitro published data. The FE model simulated CRM in the flexion, extension and neutral positions. The stress distribution, forma and relative position of the spinal cord were observed.ResultsLower von Mises stress was observed on the spinal cord after CRM in the flexion position. The spinal cord in CRM in the flexion and neutral positions had a lower sagittal diameter and cross-sectional area. In addition, the spinal cord was anteriorly positioned after CRM in the flexion position, while the spinal cord was posteriorly positioned after CRM in the extension and neutral positions.ConclusionCRM in the flexion position is less likely to injure the spinal cord, but caution is warranted when posterior vertebral osteophytes or disc herniations exist.
Highlights
Little information is available concerning the biomechanism involved in the spinal cord injury after cervical rotatory manipulation (CRM)
The results showed that CRM performed in the flexion position may be a better choice because the procedure in this position is associated with lower von Mises stress on the spinal cord and sufficient free space in the vertebral canal [39], which is in line with Feng’s theory [6]
The results suggested that CRM could significantly alter the stress distribution, the forma and the relative position of the spinal cord
Summary
Little information is available concerning the biomechanism involved in the spinal cord injury after cervical rotatory manipulation (CRM). The primary purpose of this study was to explore the biomechanical and kinematic effects of CRM on a healthy spinal cord. Little information is available concerning the biomechanism involved in the side effects or complications of CSM. Cervical rotatory manipulation (CRM), a widely used CSM technique in China developed by Feng [6], is comparable to the high-velocity thrust cervical techniques of Western medicine [7]. Spinal cord injury is a serious accident in CRM [5]. The stress, strain and relative displacement of the healthy spinal cord during CRM have not been explored. The objective of this study was (1) to explore the biomechanical and kinematic
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