Journal of Orthopaedic Surgery and Research, 2021 · DOI: https://doi.org/10.1186/s13018-021-02885-6 · Published: December 14, 2021
This study explores the biomechanical effects of cervical rotatory manipulation (CRM) on the spinal cord using a computer model. The model simulates CRM in flexion, extension, and neutral positions to observe stress distribution and spinal cord positioning. The findings suggest that CRM in the flexion position is less likely to injure the spinal cord compared to extension or neutral positions, but caution is advised if posterior vertebral osteophytes or disc herniations exist.
CRM should be used cautiously in patients with disc herniation or vertebral osteophytes around the C1-C2 segments due to increased stress in these areas during CRM.
CRM in the flexion position may be a safer option due to lower stress on the spinal cord and more free space in the vertebral canal, provided there are no posterior vertebral osteophytes or disc herniations.
Detailed medical history, physical examination, and radiographic evaluation are crucial before performing CRM to identify potential risks, such as disc herniation or ossification of the ligamentum flavum.