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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 954134, 10 pages
http://dx.doi.org/10.1155/2013/954134
Research Article

Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

1Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, USA
2Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141, USA
3Cox Chiropractic Medicine, Inc., 3125 Hobson Road, Fort Wayne, IN 46805, USA
4Chiropractic Care, Ltd., 2417 183rd Street, Homewood, IL 60430, USA
5Aaron Chiropractic Clinic, 3476 Stellhorn Road, Fort Wayne, IN 46815, USA
6Loyola University Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL 60153, USA
7Henderson Technical Consulting, 5961 Broken Bow Lane, Port Orange, FL 32127, USA

Received 25 April 2013; Revised 2 July 2013; Accepted 6 July 2013

Academic Editor: Byung-Cheul Shin

Copyright © 2013 M. R. Gudavalli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction.