The Journal of Churna Manual Medicine for Spine and Nerves (척추신경추나의학회지)

Korean Society of Chuna manual Medicine for Spine and Nerves (척추신경추나의학회)
권호 표지
DOI QR코드

DOI QR Code

Studies about Anatomical Relationships between the spinous and transverse processes of the thoracic spine using 3D-CT

3D-CT를 이용한 흉추의 극돌기와 횡돌기 사이의 관계에 대한 연구

  • Geum, Ji-Hye (Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Won-Kwang University) ;
  • Baek, Dong-Gi (Department of Internal Medicine of Korean Medicine, College of Korean medicine, Won-Kwang University) ;
  • Go, Hyun-Il (Department of Acupucture & Moxibustion, College of Korean Medicine of Wonkwkang University) ;
  • Ha, Won-Bae (Imsil-gun Health center and County hospital) ;
  • Lee, Jung-Han (Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Won-Kwang University)
  • 금지혜 (원광대학교 한의과대학 한방재활의학교실) ;
  • 백동기 (원광대학교 한의과대학 한방내과학교실) ;
  • 고현일 (원광대학교 한의과대학 침구의학교실) ;
  • 하원배 (임실군 보건의료원) ;
  • 이정한 (원광대학교 한의과대학 한방재활의학교실)
  • Received : 2019.11.15
  • Accepted : 2019.12.17
  • Published : 2019.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : There are many theories about the anatomical relationships between the thoracic spinous and transverse processes. However, these studies were all conducted on cadavers. Thus, there might be differences when applied to living individuals. Therefore, the aim of this study was to determine whether the theories were similar when measured in living individuals. Methods : We conducted studies with 10 individuals aged 20-30 using 3D-CT. Four different measurements were taken between the thoracic spinous and transverse processes. To facilitate the relationship analysis, the spinous process positioned between the traverse process of the segment and the lower segment was set to 0.5. The spinous process located at the height of the traverse process of the lower segment was set to 1. The spinous process located between the traverse process of the lower segment and the two segments below was set to 1.5. Results : Therefore, based on the aforementioned settings, T1-T4 were 1, T5-T7 were 1.5, T8-T10 were 1, and T11 and T12 were 0.5. This indicated that the spinous processes of T1-T4 and T8-T10 were equal in height to the transverse processes of the lower segment, and that T5-T7 were at the midpoint of the height of the transverse processes between the lower segment and two segments below, and T11, T12 corresponded to the midpoint between the traverse process of the segment and the lower segment. Conclusions : Neither 'Geelhoed's rule'nor 'the rule of three'was accurate when applied to living individuals. However, this study had some limitations, so further research is needed.

Keywords

References

  1. Korean Society of Chuna Manual medicine for Spine & Nerves. Chuna manual medicine. 2.5th ed. Seoul: Korean Society of Chuna Manual medicine for Spine & Nerves. 2017:44, 140-1, 143-9.
  2. Mitchell FL, Moran PS, Pruzzo NA. An Evaluation and Treatment Manual of Osteopathic Muscle Energy Procedures. Valley Park. MO : Mitchell, Moran & Pruzzo Assoc. 1979.
  3. Bassewitz HL, Herkowitz H. Functional anatomy of the spine. In: Plazeck JD, Boyce DA, eds. Orthopedic Physical Therapy Secrets. Philadelphia, PA. Hanley & Belfus. 2001:337.
  4. Dutton M. Manual Therapy of the Spine. New York, NY. McGraw-Hill. 2002.
  5. Dutton M. Orthopaedic Examination, Evaluation, and Intervention. New York, NY. McGraw-Hill. 2004.
  6. Flynn T. The Thoracic Spine and Rib Cage: Musculoskeletal Evaluation and Treatment. Boston, MA. Butterworth-Heinemann. 1996.
  7. Geelhoed MA, McGaugh J, Brewer PA, Murphy D. A new model to facilitate palpation of the level of the transverse processes of the thoracic spine. J. Orthop. Sports Phys. Ther. 2006;36(11):876-81. https://doi.org/10.2519/jospt.2006.2243
  8. Clayton KO, Sarah A. Keim J, Joseph PP, Travis LM, Kevin DT, Anthony BO. Validity of the Rule of Threes and Anatomical Relationships in the Thoracic Spine. J Am Osteoparth Assoc. 2018;118(10):645-53.
  9. Dellon AL, Mackinnon SE, Crosby PM. Reliability of two-point discrimination measurements. J Hand Surg. 1987;12(5):693-6. https://doi.org/10.1016/s0363-5023(87)80049-7
  10. Kim BJ. Understanding of Neurological Examination for clinical therapist. J Korean Soc Phys Med. 2007;2(2):229-36
  11. Edward RI, Mark RB. Bourdillon' s Spinal Manipulation, 6th Ed. Seoul: Yeong Mun Publishing Company. 2004:211-2.
  12. Menck JY, Requejo SM, Kulig K. Thoracic spine dysfunction in upper extremity complex regional pain syndrome type I. J. Orthop. Sports Phys. Ther. 2000;30:401-9. https://doi.org/10.2519/jospt.2000.30.7.401
  13. Cleland JA, Childs JD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man. Ther. 2005;10:127-35. https://doi.org/10.1016/j.math.2004.08.005
  14. Browder DA, Erhard RE, Piva SR. Intermittent cervical traction and thoracic manipulation for management of mild cervical compressive myelopathy attributed to cervical herniated disc: a case series. J. Orthop. Sports Phys. Ther. 2004;34:701-12. https://doi.org/10.2519/jospt.2004.34.11.701
  15. Cleland JA, Whitman JM, Fritz JM, Palmer JA. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. J. Orthop. Sports Phys. Ther. 2005;35:802-11. https://doi.org/10.2519/jospt.2005.35.12.802
  16. Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: a case series. J. Orthop. Sports Phys. Ther. 2006;36:152-9. https://doi.org/10.2519/jospt.2006.36.3.152
  17. Pho C, Godges J. Management of whiplash-associated disorder addressing thoracic and cervical spine impairments: a case report. J. Orthop. Sports Phys. Ther. 2004;34:511-9; discussion 520-3. https://doi.org/10.2519/jospt.2004.34.9.511
  18. Lee GJ. A system of Orthopaedic Medicine 1. Seoul:Hanmi Medical Publishing. 2015:410.
  19. Singer KP, Edmondston SJ, Day RE, Breidahl WH. Computer-assisted curvature assessment and Cobb angle determination of the thoracic kyphosis. An in vivo and in vitro comparison. Spine. 1994;19:1381-4. https://doi.org/10.1097/00007632-199406000-00012