Tissue Damage Markers after a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

Abstract

Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention. Tissue damage markers creatine phosphokinase (CPK), lactate dehydrogenase (LDH), C-reactive protein (CRP), troponin-I, myoglobin, neuron-specific enolase (NSE), and aldolase were determined in samples. Statistical analysis was performed through a 3 × 3 mixed-model ANOVA. Neither cervical manipulation nor thoracic manipulation did produce significant changes in the CPK, LDH, CRP, troponin-I, myoglobin, NSE, or aldolase blood levels. Our data suggest that the mechanical strain produced by SM seems to be innocuous to the joints and surrounding tissues in healthy subjects.

Assessment of Studies Evaluating Spinal Manipulative Therapy and Infectious Disease and Immune System Outcomes

“…The full text of 50 articles was assessed to confirm eligibility. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 Of those, 16 articles 26 , 27 , 29 , 32 , 34 , 35 , 38 , 40 , 43 , 44 , 46 , 47 , 48 , 49 , 50 , 68 reporting the results of 13 studies comprising 795 participants met the inclusion criteria and were critical...…”

“…to determine the interreviewer agreement of the screening process, which was found to be 98.5%. The full text of 50 articles was assessed to confirm eligibility . Of those, 16 articles reporting the results of 13 studies comprising 795 participants met the inclusion criteria and were critically appraised.…”

Tubular Microdiscectomy versus Conventional Surgery for Sciatica. A Comparative Prospective Enzyme Study

“…The patients are expected to have less intense low-back pain, shorter hospitalization time, faster mobilization, and to recover. 4 Several proteins have been widely used in medicine as markers of tissue damage, such as creatine phosphokinase, which is the most widely used blood parameter for the detection of striated muscle injury, 5,6 and it reaches a maximal concentration one day after surgery. 7,8 A clear dose-response relationship between creatine phosphokinase and the extent of the surgical invasiveness has been shown, 9 as well as relationships with the pressure exerted by the retractors on the paraspinal musculature and the duration of this pressure (operating time).…”

Plausible Mechanisms of Causation of Immediate Stroke by Cervical Spine Manipulation: A Narrative Review

“…Rothwell et al did reference Norris et al (2000) [ 15 ], which proposed a plausible mechanism of causation and was included in our study. Studies proposing that CSM may cause cervical artery stroke by way of vasospasm, hemostasis, subclinical endothelial injury, or turbulent flow [ 16 ] were excluded, as these mechanisms of causation have not been found plausible [ 17 , 18 ].…”