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Key Words: Spine, cervical spinal dura, ligamentum nuchae, chiropractic and spinal
biomechanics.
An investigation of connective tissue bridges originating from the
posterior spinal dura mater in the upper cervical spine
Principal investigator with Kim Humphreys, D.C., Ph.D., Canadian Memorial Chiropractic College on the
project entitled,” An investigation of connective tissue bridges originating from the posterior spinal dura
mater in the upper cervical spine,” Funded by European Chiropractic Union and British Columbia College
of Chiropractors
Anatomic Cadaver Study of the Posterior Longitudinal Ligament
Principal Investigator: Gregory D. Cramer, D.C., Ph.D.
Using similar methods as in the previously discussed study, the posterior longitudinal ligament (PLL) of
cadaveric spines is being assessed by means of magnetic resonance imaging (MRI).
Analysis of the Attachments of the Superior Head of the Lateral
Pterygoid Muscle to the Temporomandibular Joint Disc.
Principal Investigator: Michael Kiely, Ph.D.
A study evaluating the temporomandibular joint (TMJ) is being conducted. Cadavers are studied to
determine the attachments of the lateral pterygoid muscles as they relate to the TMJ, including the intraarticular discs. This study hopes to determine how these muscular attachments may relate to TMJ
syndrome.
Flexion/Distraction vs. Medical Care for Low Back Pain (HRSA II)
Principal Investigator: Ram Gudavalli, Ph.D.(Palmer), Jerrilyn Cambron, D.C., M.P.H., (NUHS)
While our first HRSA-funded study demonstrated the biomechanics of flexion/distraction therapy, the
second project is concerned with the effectiveness of flexion/distraction for the relief of chronic low back
pain. The study compares the effectiveness of chiropractic flexion/distraction therapy with non-operative
conservative therapy, physical therapy. Study participants will be randomly assigned to either the
flexion/distraction group or the physical therapy group. Patients will complete a therapeutic regimen which
lasts four weeks and will then be followed for 12 months. Primary outcomes will include patients’
perceived level of pain, health status, utilization of other health services, isometric trunk strength, ranges of
motion, and patterns of motion. This study is a collaborative effort of Palmer Center for Chiropractic
Research, National University of Health Sciences, Loyola University Stritch School of Medicine, Edward
Hines VA Hospital, Orthosport Physical Therapy Clinics, and Auburn University.
Funding: Department of Health and Human Services Chiropractic Demonstration Project under the Health
Resources and Services Administration (HRSA). Grant #2R18AH10001-04.
The Effects of Adjusting on the Zygapophysial Joints
Principal Investigator: Gregory D. Cramer, D.C., Ph.D.
A hypothesis of one of the beneficial effects of chiropractic adjusting is that adhesions develop in the
zygapophysial joints (Z joints) following hypomobility of these structures. This important connective tissue
component is thought to be alleviated by separation (gapping) of the Z joints. Side posture adjusting is
thought by many to gap the Z joint, yet no measurable difference of the Z joints before and after spinal
manipulation have ever been published. In a preliminary study we determined if differences could be
measured in the L3-L5 joint spaces before and during side posture positioning of the lumbar region and
also before and after lumbar side posture spinal adjusting. Before and after measurements of the Z joint
spaces were taken directly from before and after magnetic resonance imaging scans. Study volunteers were
randomized to one of four groups: 1) neutral position MRI followed by no treatment, followed by side
posture positioning MRI;2) neutral position MRI followed by side posture spinal adjusting followed by
neutral positioning MRI;3) neutral position MRI followed by side posture spinal adjusting followed by side
posture positioning MRI;4) neutral position MRI followed by no treatment, followed by neutral position
MRI. Gapping was identified in the side posture adjustment group (Cramer GD et al. 2000 J Manipulative
Physiol Ther, 23:380-394). A larger study funded by the National Institutes of Health/National Center for
Complementary and Alternative Medicine is currently underway. This larger study represents the first
investigator-initiated award (RO1) awarded to a chiropractic institution by the National Institutes of Health.
The results of this study should help clinicians and researchers better understand the connective tissue
component spinal fixation and should also help these same individuals determine the mechanism of action
of the lumbar side posture adjustment.
Funding of Preliminary Study: Internal and FCER, Study on 64 subjects: National Institutes of
Health/National Center for Complementary and Alternative Medicine.