Quantifying strain in the vertebral artery with simultaneous motion analysis of the head and neck: A preliminary investigation |
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| Institution: | 1. Canadian Memorial Chiropractic College, Toronto, Ontario M2H 3J1, Canada,;2. University of Calgary, Calgary, Alberta T2N 1N4, Canada,;1. Université de Lille 1, Laboratoire Géosystèmes (UMR 8217 CNRS), UFR Sciences de la Terre, Bâtiment SN5, 59655 Villeneuve d''Ascq cedex, France;2. Institut Royal des Sciences Naturelles de Belgique, DO Terre et Histoire de la Vie, Rue Vautier, 29, 1000 Bruxelles, Belgique;3. Belgique and Université de Liège, Département de Géologie, B-18, Boulevard du Rectorat, Sart-Tilman, 4000 Liège, Belgique;4. Institut Royal des Sciences Naturelles de Belgique, DO Terre et Histoire de la Vie, Service Géologique de Belgique, 13, rue Jenner, 1000 Bruxelles, Belgique;5. Muséum National d''Histoire Naturelle, UMR 7207 CNRS, Buffon Street, 75005 Paris, France;6. 269, rue Charenton, 75012 Paris, France;1. President, World Spine Care, Clinical Professor, Department of Neurology, University of California, Irvine, CA;2. Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA;3. Chairman Emeritus, McAndrews, Held & Malloy, Ltd, Chicago, IL;4. Vice Chancellor, Research and Health Policy, Palmer College of Chiropractic and Palmer Center for Chiropractic Research, Davenport, IA;5. President, NCMIC Group, Inc, Palmerton, PA;6. President, American Chiropractic Association, Arlington, VA;7. Private Practice, Goldsboro, NC;8. Professor, National University of Health Sciences, Lombard, IL;1. Spine Service, Department of Orthopaedic Surgery, St. George & Sutherland Clinical School, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia;2. School of Mechanical and Manufacturing Engineering, University of New South Wales, Kensington campus, Sydney, NSW 2052, Australia;1. Department of Endocrinology, Ghent University Hospital, Belgium;2. Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Belgium;3. Department of Pediatric Endocrinology, Ghent University Hospital, Belgium;4. Department of Hormonology, Ghent University Hospital, Belgium;5. Department of Pediatric Endocrinology, Brussels University Hospital, Belgium;1. Professor, The Departments of Psychiatry and of Community and Family Medicine, Geisel School of Medicine, The Dartmouth Institute for Health Policy and Clinical Research, Lebanon, NH;2. Instructor, The Geisel School of Medicine, The Dartmouth Institute for Health Policy and Clinical Research, Lebanon, NH;3. Research Associate, The Dartmouth Institute for Health Policy and Clinical Research, Lebanon, NH;4. Vice Chancellor, Palmer College of Chiropractic, Davenport, IA |
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| Abstract: | BackgroundSpontaneous vertebral artery dissection has significant mortality and morbidity among young adults. Unfortunately, causal mechanisms remain unclear.The purpose of this study was to quantify mechanical strain in the vertebral artery while simultaneously capturing motion analysis data during passive movements of the head and neck relative to the trunk during spinal manipulation and cardinal planes of motion.MethodsEight piezoelectric crystals (four per vertebral artery) were sutured into the lumen of the left and right vertebral arteries of 3 cadaveric specimens. Strain was then calculated as changes in length between neighboring crystals from a neutral head/neck reference position using ultrasound pulses. Simultaneously, passive motion of the head and neck on the trunk was captured using eight infrared cameras. The instantaneous strain arising in the vertebral artery was correlated with the relative changes in head position.FindingsStrain in the contralateral vertebral artery during passive flexion-rotation compared to that of extension-rotation is variable (df = 32]: − 0.61 < r < 0.55). Peak strain does not coincide with peak angular displacement during spinal manipulation and cardinal planes of motion. Axial rotation displayed the greatest amount of strain. The greatest amount of strain achieved during spinal manipulation was comparably lower than strains achieved during passive end range motions and previously reported failure limits.InterpretationThe results of this study suggest that vertebral artery strains during head movements including spinal manipulation, do not exceed published failure strains. This study provides new evidence that peak strain in the vertebral artery may not occur at the end range of motion, but rather at some intermediate point during the head and neck motion. |
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