도수교정의 검사원리

Examination Principles of Manipulation

Examination at the spine is dependent on assessment of function. At all spine levels a number of general anatomical considerations hold sway which together dictate the format of the evaluation. Because disc lesions are common and generally responsive to treatment, the examination sets out to differentiate between disc lesions and the other sources of pain as well as establishing the particular treatment that will benefit any given displacement. As elsewhere in the body, displacements give rise to certain characteristic symtoms and signs. First, the history is indicative. Second, any loose fragment in the joint restricts spinal movement in some but not all directions, producing the non-capsular pattern characteristic of internal derangement. Third, a displacement protruding posteriorly interferes with the dura mater ; apart from pain, this adversely affects the dura's normal painless mobility. Fourth, a displacement protruding laterally connects with the appropriate nerve root emerging from the dura mater. Finally, compression of the spinal cord strongly contraindicates manipulation, the primary treatment for cartilaginous displacements.