Clinical Biomechanics of Spinal Manipulation by Walter Herzog PhD

By Walter Herzog PhD

Medical BIOMECHANICS OF SPINAL MANIPULATION introduces the fundamental options of biomechanics and emphasizes its purposes to day-by-day perform, rather within the context of spinal manipulation. The chapters conceal uncomplicated mechanics, practical anatomy, mechanics of spinal manipulation, and results of spinal manipulative therapy. A bankruptcy of case stories illustrates the applying of biomechanics to spinal manipulation in real looking medical occasions.

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2 - 6 ) . Anterior shear of the superior vertebrae has been d o c u m e n t e d to cause pars and facet fracture leading to spondylolisthesis with a typical tolerance o f a n adult l u m b a r spine o f approximately 2 0 0 0 n e w t o n s . Although similar injury m e c h a n i s m s and tolerance values were observed in y o u n g porcine spine s p e c i m e n s , the type of injury appeared to be m o d u l a t e d by loading rate. Specifically, anterior shear forces produced undefinable soft tissue injury at low load rates ( 1 0 0 N / s ) , but fractures of the pars, facet face, and vertebral b o d y were observed at higher load rates ( 7 0 0 0 N / s ) .

Its function m a y be that of an extensor muscle retin a c u l u m . T h e t e n d o n s o f longissimus thoracis a n d iliocostalis l u m b o r u m pass u n d e r the LDF to their sacral and ilium a t t a c h m e n t s . Perhaps the LDF provides a f o r m of "strapping" for t h e low b a c k musculature. Hukins et a l p r o p o s e d o n theoretic grounds that t h e LDF acts t o increase the force per unit cross-sectional area that muscles can produce b y u p t o 3 0 % . T h e y suggested that this increase in force is achieved by constraining bulging o f t h e muscles w h e n they shorten.

Given the o b l i q u e fiber direction of the interspin o u s c o m p l e x (see Fig. 2 - 1 4 ) , a very likely scenario of interspinous ligament d a m a g e is falling and landing on one's b e h i n d , driving the pelvis forward on impact, creating a posterior shearing of the l u m b a r joints when the spine is fully flexed. T h e interspinous ligament is a m a j o r load bearing tissue in this e x a m p l e of high-energy loading in w h i c h anterior shear displacement is c o m b i n e d with full flexion.

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