Intradiscal Pressure Responses to Cervical Spine Posterior-Anterior Mobilization to Promote Disc Nutrition

Abstract

Research Objectives To investigate in cadaveric specimens if cervical PA mobilizations produce changes in CIDP. Causes for age-related degeneration include lack of IVD nutrition and prolonged intradiscal pressure. While studies have shown changes in cervical intradiscal pressure (CIDP) with cervical range of motion (ROM), traction and manipulation, no study has evaluated effects of cervical spine joint mobilizations on CIDP. Design Intraclass correlation coefficient [ICC (3,k)] was calculated. To assess the effect of cervical mobilizations on CIDP at different time intervals, four separate 3 (TIME: before/during/immediately following mobilization) X 2 (25 N and 45 N) repeated measures ANOVAs (Friedman) were used for each cervical level. Setting Department of Anatomy at the Université du Québec à Trois-Rivières. Participants Seven un-embalmed cadaveric specimens. Interventions Cervical PA mobilizations on cadaveric specimens using a servo-controlled linear actuator to provide 25 and 45 N forces. Measurements of CIDP were conducted using fiberoptic catheter systems at C4-5, C5-6, C6-7, and C7-T1 IVD levels. The FISO system recorded CIDP for each IVD cervical level before, during and immediately following mobilization. Main Outcome Measures Measurements of CIDP including means, standard deviation and medians. Results Reliability coefficients for CIDP measurements during, immediately after mobilization were ICC(3,k)>.98, 95% CI. Mean CIDP varied from -7.3±18.8 to 11±37.9 mmHg and from -6.5±16 to 22.8±84.5 mmHg during 25 and 45N PA mobilizations (p>.4), respectively. There was no CIDP changes during and following PA mobilizations, with exception of C5-6 CIDP at 25N or 45N (p=.05 and .018, respectively). Conclusions Cervical PA mobilizations produced substantial CIDP changes at adjacent and remote cervical segments. In vivo investigations are warranted. Author(s) Disclosures No disclosures or conflicts noted. To investigate in cadaveric specimens if cervical PA mobilizations produce changes in CIDP. Causes for age-related degeneration include lack of IVD nutrition and prolonged intradiscal pressure. While studies have shown changes in cervical intradiscal pressure (CIDP) with cervical range of motion (ROM), traction and manipulation, no study has evaluated effects of cervical spine joint mobilizations on CIDP. Intraclass correlation coefficient [ICC (3,k)] was calculated. To assess the effect of cervical mobilizations on CIDP at different time intervals, four separate 3 (TIME: before/during/immediately following mobilization) X 2 (25 N and 45 N) repeated measures ANOVAs (Friedman) were used for each cervical level. Department of Anatomy at the Université du Québec à Trois-Rivières. Seven un-embalmed cadaveric specimens. Cervical PA mobilizations on cadaveric specimens using a servo-controlled linear actuator to provide 25 and 45 N forces. Measurements of CIDP were conducted using fiberoptic catheter systems at C4-5, C5-6, C6-7, and C7-T1 IVD levels. The FISO system recorded CIDP for each IVD cervical level before, during and immediately following mobilization. Measurements of CIDP including means, standard deviation and medians. Reliability coefficients for CIDP measurements during, immediately after mobilization were ICC(3,k)>.98, 95% CI. Mean CIDP varied from -7.3±18.8 to 11±37.9 mmHg and from -6.5±16 to 22.8±84.5 mmHg during 25 and 45N PA mobilizations (p>.4), respectively. There was no CIDP changes during and following PA mobilizations, with exception of C5-6 CIDP at 25N or 45N (p=.05 and .018, respectively). Cervical PA mobilizations produced substantial CIDP changes at adjacent and remote cervical segments. In vivo investigations are warranted.