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Article 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)	Cramer GD Knudsen JT Tuck NR Jr Fonda SD Schliesser JS Fournier JT Patel P
Subject(s)	Joints / anatomy and histology Lumbar Vertebrae / anatomy and histology Magnetic Resonance Imaging Manipulation, Spinal / methods Posture
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. Click on the above link for the PubMed record for this article; full text by subscription.

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