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Table 1

Return to:   Evaluating the Relationship Among Cavitation, Zygapophyseal Joint Gapping,
and Spinal Manipulation

Inclusion and Exclusion Criteria

Inclusion CriteriaExclusion Criteria
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    Eighteen to 30 years of age (young age to decrease the likelihood of osseous and ligamentous degeneration of the lumbar region of the spine)

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    185 pounds or less for males and 145 pounds or less for females (to ensure maximum image quality)

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    No previous history of LBP lasting for more than 2 weeks, or no more than 3 episodes of back pain of brief duration (1 to 2 weeks) in any given year (to recruit healthy subjects with no history, or a minimal history, of LBP)
  • -
    Under 18 or over 30 years of age

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    Weight over 185 pounds for males and 145 pounds for females (subject will be weighed at exam)

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    History of an episode of LBP lasting for more than 2 weeks, or more than 3 episodes of back pain of brief duration (1 to 2 weeks) in any given year

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    Presence of disc degeneration, significant osteoarthritis, scoliosis of greater than 5 degrees (Cobb's angle), or other significant pathology seen on previously taken x-rays or on x-rays requested for this study (see below for reasons for x-ray, this study was attempting to assess subjects with healthy spines, also scoliosis decreases ability to adequately image the Z joints for measurement).

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    Positive findings on the standard orthopedic or neurological tests of the study physical examination form (to assess healthy individuals in the study, indications of somatic pathology or neurological deficit were exclusionary criteria)

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    Pregnancy (due to unknown risk and potential to require x-rays during the physical examination)

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    Presently breast-feeding an infant (unknown risk of MRI, also potential of need for x-ray during examination)

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    Inability of clinician to obtain cavitation [articular release(s)] during lumbar side-posture SMT given at the conclusion of the examination (the study assessed the relationship between cavitation and gapping, consequently ability to obtain a cavitation was important)
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    Intolerance to MRI procedures of the study (including claustrophobia and inability to lie on one's side for 15 minutes).

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    Significant pathology discovered on MRI scans contraindicating spinal manipulation. This criterion was evaluated during the MRI visit, immediately after the first MRI scan.