Manual Therapy
Volume 9, Issue 4 , Pages 220-227 , November 2004

Is cervical spine rotation, as used in the standard vertebrobasilar insufficiency test, associated with a measureable change in intracranial vertebral artery blood flow?

  • Jeanette Mitchell

      Affiliations

    • Physiotherapy, School of Allied Health Professions, University of the West of England, Bristol, UK
    • Corresponding Author InformationCorresponding author. Department of Zoology & Physiology, University of Wyoming, Laramie, Wyoming 82071-3166, USA
  • ,
  • David Keene

      Affiliations

    • United Bristol Healthcare NHS Trust, UK
  • ,
  • Craig Dyson

      Affiliations

    • Swansea NHS Trust, UK
  • ,
  • Lyndsay Harvey

      Affiliations

    • Gloucestershire NHS Trust, UK
  • ,
  • Christopher Pruvey

      Affiliations

    • Homerton University Hospital NHS Trust, UK
  • ,
  • Rita Phillips

      Affiliations

    • Radiography, School of Allied Health Professions, University of the West of England, Bristol, UK

Received 29 August 2003 ,Revised 2 March 2004 ,Accepted 26 March 2004.

References 

  1. Aaslid R. Transcranial Doppler sonography. Wien: Springer; 1986;
  2. Barker S, Kesson M, Ashmore J, Turner G, Conway J, Stevens D. Guidance for pre-manipulative testing of the cervical spine. Manual Therapy. 2000;5(1):37–40
  3. Bazzocchi M, Quaia E, Zuiani C, Moroldo ML. Transcranial Doppler (state of the art). European Journal of Radiology. 1998;27:141–148
  4. Brautaset NJ. Provokable bilateral vertebral artery compression diagnosed with transcranial Doppler. Stroke. 1992;23:288–291
  5. di Fabio RP.■ ■ ■ 1996.
  6. di Fabio RP. Manipulation of the cervical spine (risks and benefits). Physical Therapy. 1999;79(1):50–65
  7. Domholdt E. Physical therapy research (principles and applications). New York: WB Saunders; 2000;
  8. Dunne J. Pre-manipulative testing: predicting risk or pretending to? AJP forum (pre-manipulative testing of the cervical spine). Australian Journal of Physiotherapy. 2001;47:165
  9. Easton JD, Sherman DG. Cervical manipulation and stroke. Stroke. 1977;8:594–597
  10. Fast A, Zinicola DF, Marin EL. Vertebral artery damage complicating cervical manipulation. Spine. 1987;12:840–844
  11. Fujioka K, Douville C. Anatomy and freehand examination techniques. In:  Newell DW,  Aaslid R editor. Transcranial Doppler. New York: Raven Press Ltd; 1992;
  12. Ganong W. Review of medical physiology. Stamford, Connecticut: Appleton & Lange; 1997;
  13. Grant R. Vertebral artery testing—the Australian physiotherapy association protocol after 6 years. Manual Therapy. 1996;1:149–153
  14. Grant R. Premanipulative testing of the cervical spine—reappraisal and update. In:  Grant R editors. Physical therapy of the cervical and thoracic spine. 3rd ed.. New York: Churchill Livingstone; 2002;
  15. Gross AR, Kay TM, Kennedy C, Gasner D, Hurley L, Yardley K, et al. Clinical practice guidelines on the use of manipulation or mobilization in the treatment of adults with mechanical neck disorders. Manual Therapy. 2002;7(4):193–205
  16. Haynes M, Hart R, McGeachie J. Vertebral arteries and neck rotation (Doppler velocimeter interexaminer reliability). Ultrasound in Medicine and Biology. 2000;26(8):1363–1367
  17. Haynes MJ, Milne N. Color duplex sonographic findings in human vertebral arteries during cervical rotation. Journal of Clinical Ultrasound. 2001;29(1):14–24
  18. Hicks C. Research methods for clinical therapists (applied project design and analysis). London: Churchill Livingstone; 1999;
  19. Johnson C, Grant R, Dansie B, Taylor J, Spyropolous P. Measurement of blood flow in the vertebral artery using colour duplex Doppler ultrasound (establishment of the reliability of selected parameters). Manual Therapy. 2000;5(1):21–29
  20. Johnson CP, Scraggs M, How T, Burns J. A necropsy and histomorphometric study of abnormalities in the course of the vertebral artery associated with ossified stylohyoid ligaments. Journal of Clinical Pathology. 1995;48:637–640
  21. Kanshepolsky J, Danielson H, Flynn RE. Vertebral artery insufficiency and cerebral infarct due to manipulation of the neck. Bulletin of the Los Angeles Neurological Society. 1972;37:62–66
  22. Kaps M, Seidel G, Bauer T, Behrmann B. Imaging of the intracranial vertebrobasilar system using color-coded ultrasound. Stroke. 1992;23:1577–1582
  23. Kuether TA, Nesbit GM, Clark WM, Barnwell SL. Rotational vertebral artery occlusion (a mechanism of vertebrobasilar insufficiency). Neurosurgery. 1997;41(2):427–432
  24. Li YK, Zhang YK, Lu CM, Zhong SZ. Changes and Implications of the blood flow velocity of the vertebral artery during rotation and extension of the head. Journal of Manipulative and Physiological Therapeutics. 1999;22(2):91–95
  25. Libby P. Changing concepts of atherogenesis. Stroke. 2000;247:349–358
  26. Licht PB, Christensen HW, Hojgaard P, Hoilund-Carlsen PF. Triplex ultrasound of vertebral artery flow during cervical rotation. Journal of Manipulative and Physiological Therapeutics. 1998;21(1):27–31
  27. Magarey M, Coughlan B, Rebbeck T. APA pre-manipulative testing protocol for the cervical spine (researched and renewed part II—revised clinical guidelines). In:  Singer K editors. Proceedings of the Seventh Scientific Conference of the IFOMT. Perth: University of Western Australia; 2000;
  28. Maher C. AJP forum (pre-manipulative testing of the cervical spine). Australian Journal of Physiotherapy. 2001;47:163–164
  29. Mann T, Refshauge KM. Causes of complications from cervical spine manipulation. Australian Journal of Physiotherapy. 2001;47:255–266
  30. Mitchell J. Changes in vertebral artery blood flow following normal rotation of the cervical spine. Journal of Manipulative and Physiological Therapeutics. 2003;26(6):347–351
  31. Mitchell J, McKay A. Comparison of left and right vertebral artery intracranial diameters. The Anatomical Record. 1995;242:350–354
  32. Refshauge KM. Rotation (a valid premanipulative dizziness test? Does it predict safe manipulation?). Journal of Manipulative and Physiological Therapeutics. 1994;17(1):15–19
  33. Refshauge KM, Parry S, Shirley D, Larsen D, Rivett DA, Boland R. Professional responsibility in relation to cervical spine manipulation. Australian Journal of Physiotherapy. 2002;48:171–185
  34. Rivett DA, Milburn PD, Chapple C. Negative pre-manipulative vertebral artery testing despite occlusion (a case of false negativity?). Manual Therapy. 1998;3(2):102–107
  35. Rivett DA, Sharples KJ, Milburn PD. Effect of premanipulative tests on vertebral artery and internal carotid artery blood flow (a pilot study). Journal of Manipulative and Physiological Therapeutics. 1999;22(6):368–375
  36. Ross R. Atherosclerosis—an inflammatory disease. New England Journal of Medicine. 1999;340:115–126
  37. Rossitti S, Volkmann R. Changes of blood flow velocity indicating mechanical compression of the vertebral arteries during rotation of the head in the normal human measured with transcranial Doppler sonography. Arquivos de Neuro-Psiquiatria. 1995;53(1):26–33
  38. Rossitti S, Volkmann R, Lofgren J. Changes of blood flow velocity in the vertebro-basilar circulation during rotation of the head in the normal human. Biomechanics Seminar. 1992;6:92–99
  39. Scheel P, Ruge C, Schoning M. Flow velocity and flow volume measurements in the extracranial carotid and vertebral arteries in healthy adults (reference data and the effects of age). Ultrasound in Medicine and Biology. 2000;26:1261–1266
  40. Schoning M, Walter J. Evaluation of the vertebrobasilar-posterior system by transcranial color duplex sonography in adults. Stroke. 1992;23:1280–1286
  41. Schoning M, Walter J, Scheel P. Estimation of cerebral blood flow through color duplex sonography of the carotid and vertebral arteries in healthy adults. Stroke. 1994;25:17–22
  42. Smith RA, Estridge MN. Neurologic complications of head and neck manipulations. Journal of the American Medical Association. 1962;182:528–531
  43. Taylor K, Burns P, Wells P, editor. Clinical applications of Doppler ultrasound. New York: Raven Press Ltd; 1995.
  44. Terenzi T, di Fabio D. The role of transcranial Doppler sonography in the identification of patients at risk of cerebral and brainstem ischemia. Journal of Manipulative and Physiological Therapeutics. 1996;19(6):406–414
  45. Theil H. Gross morphology and pathoanatomy of the vertebral arteries. Journal of Manipulative and Physiological Therapeutics. 1991;14(2):133–141
  46. Theil H, Wallace K, Donat J, Yong-Hing K. Effect of various head and neck positions on vertebral artery blood flow. Clinical Biomechanics. 1994;9:105–110
  47. Trattnig S, Hubsch P, Schuster H, Polzleitner D. Color-coded Doppler imaging of normal vertebral arteries. Stroke. 1990;21:1222–1225
  48. Zaina C, Grant R, Johnson C, Dansie B, Taylor J, Spyropolous P. The effect of cervical rotation on blood flow in the contralateral vertebral artery. Manual Therapy. 2003;8(2):103–109

PII: S1356-689X(04)00033-5

doi: 10.1016/j.math.2004.03.005

Manual Therapy
Volume 9, Issue 4 , Pages 220-227 , November 2004