Immediate changes in radiographically determined lateral flexion range of motion following a single cervical HVLA manipulation in patients presenting with mechanical neck pain: A case series

Abstract

Background It is generally assumed that inter-vertebral joint dysfunction results in a temporary reduction of mobility of a spinal segment and it has been purported that spinal manipulation can directly affect the biomechanical behaviour of the spine. Functional X-rays are used to assess dynamic alterations of spinal function. Objective The aim of this case series was to describe the immediate changes of inter-vertebral motion at an identified dysfunctional cervical segment, as measured by functional X-rays in lateral flexion, following a supine cervical rotation manipulation in patients presenting with mechanical neck pain. Methods Fifteen patients who presented with mechanical neck pain and who exhibited inter-vertebral joint dysfunction at C3–C4 or C4–C5 levels were recruited to participate in this case series. The radiological distance between the transverse process of the identified hypomobile vertebra and the transverse process of the subjacent vertebra, was measured pre- and 5 min post-manipulation during contralateral side flexion. Results Analysis of the pre-post-intervention radiographs showed a significant increase ( P = 0.01) of the distance between the transverse process on the dysfunctional side following cervical manipulation. The mean pre-manipulative inter-vertebral radiological measurement was 18.9 mm (SD 2.1), and 20.6 mm (SD 2.1) at the post-manipulative assessment. Conclusions These preliminary results demonstrated a trend toward an increase in inter-vertebral motion at the hypomobile segment, measured by functional radiography.