Zhen Deng1,2, Kuan Wang3,4, Huihao Wang2,4, Tianying Lan5, Hongsheng Zhan6,7, Wenxin Niu8. 1. Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201900, China. 2. Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, China. 3. Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China. 4. Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201203, China. 5. Nephrology Department of Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201203, China. 6. Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, China. zhanhongsheng2010@163.com. 7. Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201203, China. zhanhongsheng2010@163.com. 8. Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China. niu@tongji.edu.cn.
Abstract
PURPOSE: Traditional Chinese cervical manipulation (TCCM) has been claimed as an effective treatment for diseases of the cervical spine, but its biomechanical effects on the vertebral body and intervertebral discs remain unclear. The aim of this study was to develop and validate a detailed finite element model of cervical spine, which was then used to investigate the biomechanical response of the cervical spine to TCCM. METHODS: The model of a C2-T1 cervical spine was constructed based on CT images of a healthy male volunteer and validated against published in vitro studies under different loading conditions. The detailed force-time data of TCCM were measured on the same volunteer through dynamometric diaphragms. The data were applied on the validated finite element model to simulate TCCM. RESULTS: The current model could offer potentials to effectively reflect the behavior of human cervical spine suitable for biomechanics studies of TCCM. Under simulated TCCM condition, the stress distributions in cervical spine and intervertebral discs could not be completely explained through the traditional theory. CONCLUSION: Spinal manipulation, or TCCM, might play no role in reducing intradiscal pressure for treating cervical spondylosis. It could cause less stress concentration in intervertebral discs while operating spinal manipulation or TCCM when the adjustment points was chosen near the root of spinous process than the top of spinous process.
PURPOSE: Traditional Chinese cervical manipulation (TCCM) has been claimed as an effective treatment for diseases of the cervical spine, but its biomechanical effects on the vertebral body and intervertebral discs remain unclear. The aim of this study was to develop and validate a detailed finite element model of cervical spine, which was then used to investigate the biomechanical response of the cervical spine to TCCM. METHODS: The model of a C2-T1 cervical spine was constructed based on CT images of a healthy male volunteer and validated against published in vitro studies under different loading conditions. The detailed force-time data of TCCM were measured on the same volunteer through dynamometric diaphragms. The data were applied on the validated finite element model to simulate TCCM. RESULTS: The current model could offer potentials to effectively reflect the behavior of human cervical spine suitable for biomechanics studies of TCCM. Under simulated TCCM condition, the stress distributions in cervical spine and intervertebral discs could not be completely explained through the traditional theory. CONCLUSION: Spinal manipulation, or TCCM, might play no role in reducing intradiscal pressure for treating cervical spondylosis. It could cause less stress concentration in intervertebral discs while operating spinal manipulation or TCCM when the adjustment points was chosen near the root of spinous process than the top of spinous process.
Entities:
Keywords:
Biomechanics; Cervical spine; Finite element analysis; In vivo measurement; Manual therapy
Authors: Pierre Côté; Jessica J Wong; Deborah Sutton; Heather M Shearer; Silvano Mior; Kristi Randhawa; Arthur Ameis; Linda J Carroll; Margareta Nordin; Hainan Yu; Gail M Lindsay; Danielle Southerst; Sharanya Varatharajan; Craig Jacobs; Maja Stupar; Anne Taylor-Vaisey; Gabrielle van der Velde; Douglas P Gross; Robert J Brison; Mike Paulden; Carlo Ammendolia; J David Cassidy; Patrick Loisel; Shawn Marshall; Richard N Bohay; John Stapleton; Michel Lacerte; Murray Krahn; Roger Salhany Journal: Eur Spine J Date: 2016-03-16 Impact factor: 3.134