The relative effectiveness of two different approaches to adjust a fixated segment in the treatment of facet syndrome in the cervical spine

Abstract

The aim of this investigation was to determine the relative efficacy of two approaches to adjusting for facet syndrome in the cervical spine. It was hypothesised that by adjusting the top segment of a primary fixation in the direction of the restriction, as well as the bottom segment in the opposite direction, there would be a significantly greater improvement than by only adjusting the top segment of a primary fixation in the direction of restriction. Thirty subjects, diagnosed as having cervical facet syndrome, were randomly divided into two treatment groups, each consisting of fifteen patients. The first treatment group received a single adjustment in the direction of the restriction only. The second treatment group had a bilateral adjustment: the top segment of the fixation in the direction of the restriction as well as the bottom segment in the opposite direction. Soft tissue therapy was used in both treatment groups as a preadjustment procedure. The research project was carried out where both groups received a maximum of eight treatments over a minimum of four weeks. After a follow-up period of a month the patients were re-assessed. Measurements of the cervical spine ranges of motion with the CROM goniometer and the completion of the Numerical Rating Scale 101, CMCC Neck Disability Index and the McGill Short Form questionnaires were performed before the first, fourth and final treatments as well as at the month fa IIowup consultation.