Restoring Spinal Integrity With Computer-Aided Spinal Adjustments
By Robert W. Baritz, D.C.
Correction of mechanical segmental dysfunction of the spine has been demonstrated by many researchers and clinicians as helpful, if not essential, in resolving spinal problems. [1-7]
Hypomobility, hypermobility, fixations and loss of joint play are some of the terms used to describe mechanical segmental dysfunction. These spinal conditions are often grouped under the term kinesiopathology and are generally considered to be part of the subluxation complex. [8,9]
An advanced technical instrument for spinal analysis and adjustment, such as the ProAdjuster by Dr. Pisciottano(tm), implements a sophisticated software package designed to assist in locating and correcting segmental spinal dysfunction. Each region (cervical, thoracic, lumbar) of the spine is analyzed separately, and the results are displayed graphically. Pre and post adjustment readings may be displayed on the same graph to illustrate any changes.
At the heart of the instrument is a piezoelectric sensor, whose crystals can produce electricity when impacted with kinetic energy. The impulse generated varies according to the nature of the impact, and very fine measurements can be made.
Because of their utility and reliability, piezoelectric sensors are widely used in aerospace and engineering measurement and testing applications. Their use for measuring vibrations and bone movements in mammals is well established. [10-15]
History
A 30-year-old male came to our office on July 28, 2000, complaining of headaches, neck pain and stiffness and low back pain.
One week earlier, he had been injured when a car ran a stop sign, struck his motorcycle and knocked him to the ground. Emergency room personnel reported a neck sprain with numbness in the upper extremity, along with abrasions, headaches and back pain. The patient was sent home to use painkillers and ice packs.
Prior to the injury, he worked as a health-care supervisor, was an avid motorcyclist and recreational soccer player and trained regularly in a gym. He had been out of work since the accident.
The patient had been previously seen in my office for an earlier injury, and he returned because he wasn’t getting improvement from conventional treatment for the current injury.
Objective Findings and Testing
The initial examination in my office demonstrated decreased cervical and lumbar range of motion, partial sensory loss of the upper right extremity, weakness on right grip strength test, positive cervical foraminal compression test and normal deep tendon reflexes.
Cervical X-rays revealed hypolordosis and slight spondylosis at C5. Lumbar X-rays revealed small anterior insertional annular tears of the L2, L3, L4 discs with reactive spondylosis and transitional S1.
A cervical MRI demonstrated a right paracentral disc herniation at C6-7, with mild effacement of the underlying core, with probable impingement of the nerve root and a small disc bulge at C7-T1. Computerized muscle strength testing demonstrated significant weakness in the cervical muscles.
Care Plan
From July 28 to December 15, 2000, this patient was seen 38 times. Office visits included adjustments with the ProAdjuster, using frequency corrected repetitive percussions. The ProAdjuster applies a traction force on the disc above the segment being adjusted; the force is applied along the P-to-A plane rather than along the long axis of the body. This results in non-linear disc traction.
MRI studies of linear disc traction repeatedly demonstrated evidence of disc herniation reduction. However, linear disc traction works to the detriment of normalizing the lordotic curvatures. Non-linear disc traction can have the same benefits as linear traction without the unwanted side effects.[16]
Repetitive force adjustments result in a relatively painless restoration of motion to the motion units of the body. This joint mobilization results in a favorable response of the chemical and mechanical alterations from an intra-articular disorder. [17]
The patient began Pettibon wobble chair exercises, which bring the spine through a series of motions to "improve joint integrity thereby preventing further adhesions by nourishing the articular cartilage. The integrity of the joint forms the basis for further strengthening and endurance training." [18]
Supervised strength training was performed on "Nautilus"-type equipment.
At home, the patient continued the "wobble chair exercises."
Outcome
The patient made steady progress under care and returned to light duty and then to his regular work duties. During an examination on December 15, he demonstrated full pain-free range of the motion in the cervical and lumbar spine. No sign of sensory deficit appeared, and the cervical foraminal compression test was negative. His right upper extremity grip strength was improved by 50 percent.
The patient was very pleased with the outcome and stated that he "has been feeling much better" and that he has "no symptoms."
When used in combination with specific rehabilitation procedures, a computerized technical instrument, such as the ProAdjuster, can be an effective method of relieving the effects of spinal disc derangement.
About the author: Robert W. Baritz, D.C., a 1985 cum laude graduate of Los Angeles College of Chiropractic, has been involved with instrument adjusting since 1986 and maintains a chiropractic and rehabilitation clinic in Brockton, Mass. Inquiries may be sent to him by E-mail at rbaritz@aol.com, or to Dr. Pisciottano at Proadjuster@aol.com.
References
1. Schafer, R.C., Faye, L.J., Motion Palpation and Chiropractic Technique, Huntington Beach, CA: Motion Palpation Institute, 1989.
2. Gillet, H.J, Belgian Chiropractic Research Notes, Huntington Beach, CA: Motion Palpation Institute, 1984.
3. Maitland, G.D., Peripheral Manipulation, London: Butterworths, 1976.
4. Mennell, J.M., Back Pain, Diagnosis and Treatment Using Manipulative Techniques, Boston: Little, Brown and Company, 1960.
5. Fuhr, A.W., et al., Activator Methods Chiropractic Technique, Mosby, 1997.
7. Christensen, K.D., Clinical Chiropractic Biomechanics, Iowa, Education Division, Foot Levelers, Inc., 1984.
8. Schafer and Cianciulli, Basic Chiropractic Procedural Manual, Associated Chiropractic Academic Press, 4th ed., 1984.
9. International Chiropractors Association, Recommended Clinical Protocols And Guidelines For The Practice Of Chiropractic, 2000, p. 24.
10. Smith, et al., "Skin Accelerometer Displacement and Relative Bone Movement of Adjacent Vertebra in Response to Chiropractic Percussion Thrusts," JMPT, Vol. 12, No. 1, Feb., 1989.
11. Hinz, et al., "Examination of Spinal Column Vibrations: A Non-Invasive Approach," Eur J Appl Physiol, 1988, 57:70-73.
12. Smith, "In Vitro Spinal Biomechanics Experimental Methods and Apparatus," Spine, Vol. 16, No. 10, 1991.
13. "Studies on the Transmission of Vibrations in Human Organism Exposed to Low-Frequency Whole-Body Vibratrion," ACTA Physiol. Pol., 27:4, 1976.
14. Panjabi, M., et al., "In Vivo Measurements of Spinal Column Vibrations," J of Bone and Joint Surgery, Vol. 68-A, No. 5., June, 1986.
15. Fuhr, A., Smith, D., "Accuracy of Piezoelectric Accelerometers Measuring Displacement of a Spinal Adjusting Instrument," JMPT, Vol. 9, No. 1, March, 1986.
16. Abrams, M.D., Calif. Journal of Alternative Medicine, Dec., 1999, Vol. 17.
17. McCarty, Darnell, "Rehabilitation of the Temporomandibular Joint Through the Application of Motion," Craniopathy, Oct. 11, 1993, (4):298-307.
18. Davis, G.J., A Compendium of Isokinetics and Clinical Usage, La Crosse: S&S Publishers, 1984.
