title: Vertebral artery flow and cervical manipulation: an experimental study.
abstract: BACKGROUND
  Spinal manipulation therapy is used by millions of patients each year to relieve symptoms caused by biomechanical dysfunction of the spine. Cerebrovascular accidents in the posterior cerebral circulation are a feared complication, but little research has been done on vertebral artery hemodynamics during cervical manipulation.
  
  
  OBJECTIVE
  The purpose of this study was to develop an experimental model for investigations of volume blood flow changes in the vertebral arteries during premanipulative testing of these vessels and during spinal manipulation therapy of the cervical spine.
  
  
  METHODS
  An experimental study in a university biomedical laboratory.
  
  
  METHODS
  The vertebral arteries were exposed in 8 adult pigs after extensive mediastinal dissection. Volume blood flow was measured on both sides simultaneously by advanced transit-time flowmetry.
  
  
  RESULTS
  After cervical manipulation, the vertebral artery volume blood flow increased significantly for 40 seconds before returning to baseline values in less than 3 minutes. We found no significant changes in volume flow during premanipulative testing of the vertebral arteries (DeKleyn's test).
  
  
  CONCLUSIONS
  We present an experimental model for investigations of vertebral artery hemodynamics during biomechanical interventions. We found a modest and transient effect of cervical manipulation on vertebral artery volume flow. The model may have further applications in future biomechanical research, for example, to determine whether any of several spinal manipulative techniques imposes less strain on the vertebral artery, thereby reducing possible future cerebrovascular accidents after such treatment.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Odense University Hospital, Denmark.
authors.forename: P B
authors.initials: PB
authors.lastname: Licht
authors.forename: H W
authors.initials: HW
authors.lastname: Christensen
authors.forename: P
authors.initials: P
authors.lastname: Svendensen
authors.forename: P F
authors.initials: PF
authors.lastname: Høilund-Carlsen
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D002574:Cervical Vertebrae / Q000098:blood supply*; D004195:Disease Models, Animal; D005260:Female; D016014:Linear Models; D020393:Manipulation, Spinal; D012039:Regional Blood Flow; D013552:Swine; D014711:Vertebral Artery / Q000502:physiology*