Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 14773
  Title Effects of side-posture positioning and side-posture adjusting on the lumbar zygapophysial joints as evaluated by magnetic resonance imaging: a before and after study with randomization [randomized controlled trial]
URL http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10951308
Journal J Manipulative Physiol Ther. 2000 Jul-Aug;23(6):380-394
Author(s)
Subject(s)
Peer Review Yes
Publication Type Randomized Controlled Trial
Abstract/Notes OBJECTIVE: To test the a priori hypothesis that one of the positive mechanisms of action of chiropractic side-posture manipulation (adjusting) of the lumbar spine is to separate, or gap, the zygapophysial (Z) joints.

DESIGN: Before and after study with randomization.

SETTING: Chiropractic college clinic and magnetic resonance imaging (MRI) facility.

PARTICIPANTS: Sixteen healthy student volunteers (8 men and 8 women) ages 22 to 29 years with no history of significant low back pain. Nineteen volunteers were screened, with 3 disqualified from the study. Subjects were randomized into 4 groups, each with 2 men and 2 women.

INTERVENTIONS: Lumbar side-posture spinal adjusting (manipulation) and side-posture positioning.

MAIN OUTCOME MEASURES: Comparison of anterior to posterior measurements of the Z joints from MRI scans taken before and after side-posture spinal adjusting and before and after side-posture positioning, and a rigorous subjective evaluation protocol of the Z joints by 3 radiologists blinded to the randomized groups.

MAIN RESULTS: Observers making measurements were blinded to what group subjects were placed in and whether they were measuring first or second scans; radiologists were blinded to what group subjects were assigned. Differences were found between the groups. Those receiving side-posture spinal adjusting and remaining in side posture showed the greatest increase in gapping (0.7 mm vs 0.0 mm for controls).

CONCLUSIONS: Lumbar side-posture spinal adjusting produced increased separation (gapping) of the zygapophysial joints. Side-posture positioning also produced gapping, but less than that seen with lumbar side-posture adjusting. A larger clinical trial should be performed to further define the results of this study.

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