ArticleChiropractic & manual therapies2022
Kinematics of the head and associated vertebral artery length changes during high-velocity, low-amplitude cervical spine manipulation.
Article in Chiropractic & manual therapies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- The effects of mobilization and manipulation on mortality and structure, function and inflammatory markers in cervical blood vessels: a systematic review and meta-analysis of studies in healthy animals and animals with pre-existing vascular pathology.Frontiers in cardiovascular medicine · 2025Pooled it
- Mechanisms of manipulation: a systematic review of the literature on immediate anatomical structural or positional changes in response to manually delivered high-velocity, low-amplitude spinal manipulation.Chiropractic & manual therapies · 2024Pooled it
- Reporting of adverse events associated with spinal manipulation in randomised clinical trials: an updated systematic review.BMJ open · 2023Pooled it
- Spinal manipulation/mobilization: past, present, future.Chiropractic & manual therapies · 2025Article
- Kinematic and mechanical assessment of seated lumbar rotation manipulation: force, velocity and orientation in three dimensions.Frontiers in bioengineering and biotechnology · 2025Article
- Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers.The Journal of manual & manipulative therapy · 2023Article
- What is manipulation? A new definition.BMC musculoskeletal disorders · 2023Review
- Chiropractic Management of Neck Pain Complicated by Symptomatic Vertebral Artery Stenosis and Dizziness.The American journal of case reports · 2022Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCervical spine manipulation (CSM) is a frequently used treatment for neck pain. Despite its demonstrated efficacy, concerns regarding the potential of stretch damage to vertebral arteries (VA) during CSM remain. The purpose of this study was to quantify the angular displacements of the head relative to the sternum and the associated VA length changes during the thrust phase of CSM.
methodsRotation and lateral flexion CSM procedures were delivered bilaterally from C1 to C7 to three male cadaveric donors (Jan 2016-Dec 2019). For each CSM the force-time profile was recorded using a thin, flexible pressure pad (100-200 Hz), to determine the timing of the thrust. Three dimensional displacements of the head relative to the sternum were recorded using an eight-camera motion analysis system (120-240 Hz) and angular displacements of the head relative to the sternum were computed in Matlab. Positive kinematic values indicate flexion, left lateral flexion, and left rotation. Ipsilateral refers to the same side as the clinician's contact and contralateral, the opposite. Length changes of the VA were recorded using eight piezoelectric ultrasound crystals (260-557 Hz), inserted along the entire vessel. VA length changes were calculated as D = (L
resultsIrrespective of the type of CSM, the side or level of CSM application, angular displacements of the head and associated VA length changes during the thrust phase of CSM were small. VA length changes during the thrust phase were largest with ipsilateral rotation CSM (producing contralateral head rotation): [mean ± SD (range)] whole artery [1.3 ± 1.0 (- 0.4 to 3.3%)]; and V3 segment [2.6 ± 3.6 (- 0.4 to 11.6%)].
conclusionsMean head angular displacements and VA length changes were small during CSM thrusts. Of the four different CSM measured, mean VA length changes were largest during rotation procedures. This suggests that if clinicians wish to limit VA length changes during the thrust phase of CSM, consideration should be given to the type of CSM used.
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