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Defining the effect of cervical manipulation on vertebral artery integrity: establishment of an animal model.

Abstract：

BACKGROUND:Cervical spine manipulation is most often performed to affect relief of musculoskeletal complaints of the head and neck. Performed typically without complication, this modality is thought to be a potential cause of cerebrovascular injury, although a cause-effect relation has yet to be established. To explore this relation, an experimental platform is needed that is accessible and biologically responsive. OBJECTIVE:To establish an animal model capable of accommodating (1) direct study of its vertebral arteries and (2) creation of controlled interventions simulating arterial injury. STUDY DESIGN:Descriptive. METHODS:Under fluoroscopic guidance, an ultrasonic catheter was inserted into the left vertebral artery of 3 anesthetized dogs. The ultrasonic probe was then drawn proximally through the artery at a specific rate, and cross-sectional images of the vessel were collected. These images were then reconstructed to provide a variety of 2- and 3-dimensional representations of the vessel. This procedure was repeated after the overinflation and/or displacement of an angiographic balloon within the vertebral artery itself. RESULTS:The resulting ultrasonic images were able to delineate the structural layers that constitute the vertebral artery. Analysis of 2- and 3-dimensional reconstructions before and after angiographic intervention revealed the creation of discrete vascular injuries (aneurysm or dissection). CONCLUSIONS:For the first time, an animal model has been established that permits direct interrogation of the internal structures of the vertebral artery. This model can also be manipulated to create "preexisting" vascular injuries that are thought to be possible prerequisites for cerebrovascular injury associated with manipulation. As a result, an experimental platform has been established that is capable of providing investigators of all backgrounds with the ability to quantify biologic and mechanical outcomes of cervical manipulation.

journal_name

J Manipulative Physiol Ther

journal_title

Journal of manipulative and physiological therapeutics

authors

Kawchuk GN,Wynd S,Anderson T

doi

10.1016/j.jmpt.2004.10.005

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

539-46

issue

eissn

0161-4754

issn

1532-6586

pii

S0161475404002374

journal_volume

pub_type

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Defining the effect of cervical manipulation on vertebral artery integrity: establishment of an animal model.