The anterior shear and distraction tests for craniocervical instability. An evaluation using magnetic resonance imaging

Manual Therapy
P G OsmotherlyLindsay J Rowe

Abstract

Screening for integrity of the ligaments of the craniocervical complex has been suggested prior to the application of manual techniques to the upper cervical spine. However, most tests proposed lack validation limiting their usefulness clinically. This study examined the effect of the anterior shear test for the transverse ligament and the distraction test for the tectorial membrane in normal volunteers. MRI was performed in supine in neutral and end-range stress test positions in 16 individuals using proton density-weighted sequences and a standard head coil in a 3-T system. Measurements were made with respect to a strictly standardised protocol. The anterior shear test was assessed using changes in atlantodental interval and distance from the anterior arch of the atlas to the posterior aspect of the odontoid process. Distraction testing for the tectorial membrane was assessed by changes in basion-dental interval and by direct measurement of the tectorial membrane. Differences were compared using Wilcoxon Sign Rank tests or paired t-test depending upon each variables assessment of normality. Anterior shear testing resulted in a 0.41 mm mean increase in atlantodental interval (p = 0.03) and 0.35 mm mean increase in axial plane ...Continue Reading

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Citations

Nov 13, 2015·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Roy RiascosClark West
Jan 18, 2014·Orthopaedics & Traumatology, Surgery & Research : OTSR·P C Ivancic
Aug 26, 2016·The Journal of Manual & Manipulative Therapy·Shala Cunningham
Mar 30, 2020·Surgical and Radiologic Anatomy : SRA·Sefkan TanriseverEda Didem Yalçin
Oct 27, 2020·Journal of Craniovertebral Junction and Spine·Benoît BeyerPierre-Michel Dugailly

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