Trial reportJournal of manipulative and physiological therapeutics2013
Magnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding.
Trial report in Journal of manipulative and physiological therapeutics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Systematic review on biomechanical effects of high-velocity, low amplitude spinal manipulation.PloS one · 2025Pooled it
- Self-Administered Traction as an Adjunct in the Chiropractic Treatment of Low Back Pain: A Case Report.Journal of chiropractic medicine · 2024Article
- Article
- In vivo measurement of intradiscal pressure changes related to thrust and non-thrust spinal manipulation in an animal model: a pilot study.Chiropractic & manual therapies · 2022Article
- Reliability of Human Lumbar Facet Joint Degeneration Severity Assessed by Magnetic Resonance Imaging.Journal of manipulative and physiological therapeutics · 2020Article
- A Novel Treatment Combination for Failed Back Surgery Syndrome, With a 41-Month Follow-Up: A Retrospective Case Report.Journal of chiropractic medicine · 2018Article
- Short-term increase in discs' apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain.Scientific reports · 2018Article
- Article
- Spinal manipulation and therapeutic exercises in treating post-surgical resurgent lumbar radiculopathy.Oxford medical case reports · 2017Article
- Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study.Journal of manipulative and physiological therapeutics · 2016Article
- A quantitative assessment of the mechanical effects on the lumbar spine and the effects on straight leg raising and lumbar flexion of segmental sustained rotation.Journal of physical therapy science · 2016Article
- Neural responses to the mechanical characteristics of high velocity, low amplitude spinal manipulation: Effect of specific contact site.Manual therapy · 2015Article
- Grading Osteoarthritic Changes of the Zygapophyseal Joints from Radiographs: A Reliability Study.Journal of manipulative and physiological therapeutics · 2015Article
- Feasibility of using the patient-reported outcomes measurement information system in academic health centers: case series design on pain reduction after chiropractic care.Journal of chiropractic medicine · 2014Article
- A Feasibility Study to Assess Vibration and Sound From Zygapophyseal Joints During Motion Before and After Spinal Manipulation.Journal of manipulative and physiological therapeuticsArticle
- Effects of unilateral facet fixation and facetectomy on muscle spindle responsiveness during simulated spinal manipulation in an animal model.Journal of manipulative and physiological therapeuticsArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe purpose of this study was to quantify lumbar zygapophyseal (Z) joint space separation (gapping) in low back pain (LBP) subjects after spinal manipulative therapy (SMT) or side-posture positioning (SPP).
methodsThis was a controlled mechanisms trial with randomization and blinding. Acute LBP subjects (N = 112; four n = 28 magnetic resonance imaging [MRI] protocol groups) had 2 MRI appointments (initial enrollment and after 2 weeks of chiropractic treatment, receiving 2 MRI scans of the L4/L5 and L5/S1 Z joints at each MRI appointment. After the first MRI scan of each appointment, subjects were randomized (initial enrollment appointment) or assigned (after 2 weeks of chiropractic treatment appointment) into SPP (nonmanipulation), SMT (manipulation), or control MRI protocol groups. After SPP or SMT, a second MRI was taken. The central anterior-posterior joint space was measured. Difference between most painful side anterior-posterior measurements taken postintervention and preintervention was the Z joint "gapping difference." Gapping differences were compared (analysis of variance) among protocol groups. Secondary measures of pain (visual analog scale, verbal numeric pain rating scale) and function (Bournemouth questionnaire) were assessed.
resultsGapping differences were significant at the first (adjusted, P = .009; SPP, 0.66 ± 0.48 mm; SMT, 0.23 ± 0.86; control, 0.18 ± 0.71) and second (adjusted, P = .0005; SPP, 0.65 ± 0.92 mm; SMT, 0.89 ± 0.71; control, 0.35 ± 0.32) MRI appointments. Verbal numeric pain rating scale differences were significant at first MRI appointment (P = .04) with SMT showing the greatest improvement. Visual analog scale and Bournemouth questionnaire improved after 2 weeks of care in all groups (both P < .0001).
conclusionsSide-posture positioning showed greatest gapping at baseline. After 2 weeks, SMT resulted in greatest gapping. Side-posture positioning appeared to have additive therapeutic benefit to SMT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.