Cervical spine mobilizations in subjects with chronic neck problems: An interventional MRI study

Abstract

Manual therapists frequently use posteroanterior mobilisation as both an examination tool and a form of conservative treatment. At present our knowledge of the principles underlying this technique are scant. This study aimed to investigate changes in vertebral kinematics and soft tissue displacement as a result of a sustained posteroanterior (PA) mobilisation applied to the cervical spine of a subject with a history of chronic neck pain.

Five subjects were recruited and written informed consent obtained. Subjects were scanned using a General Electric Signa SPI0 Open Interventional MRI scanner. Subjects were scanned in the prone position with their necks in both neutral and flexed positions. In each position a PA mobilisation to the 2nd and 6th cervical vertebrae was performed. Sagittal images of the spine were obtained prior to, during and following the mobilisation, from which measures of vertebral angulation and translation were recorded. Measurements of intervertebral angulation and translation demonstrated little if any motion during the application of a PA mobilisation. Marked and significant changes were seen in terms of soft tissue compression and in some instances overall angulation of the cervical spine.

These initial studies suggest that the application of a PA mobilisation to the cervical spine produces minimal if any intervertebral motion. This is in agreement with earlier studies investigating motion in healthy normal spines.