The relative effectiveness of adjusting the ipsilateral side of a fixation versus adjusting the contralateral side of a fixation in the management of facet syndrome of the cervical spine

Abstract

The purpose of this study was to determine the relative effectiveness of adjusting the ipsilateral side of the fixated segment versus adjusting the side contralateral to that of the fixated segment, in patients with facet syndrome of the cervical spine, in terms of subjective and objective clinical fmdings, as well as patient comfort. The rationale for adjusting the cervical spine on the side contralateral to fixation is that the spinal dysfunction is of a soft tissue nature, as opposed to joint or bone. Thus the effectiveness of the spinal adjustment may be due to a reprogramming of the central nervous system, whereby the principal effect seems to be to stretch muscles to their normal resting length before spinal mobility can be restored. Adjusting the side opposite to the fixation may cause a sudden stretch of the muscle spindle resulting in a barrage of afferent impulses to the central nervous system, which reflexly turns down the gamma motor neuron tone. The resetting of the gamma motor neuron tone and resultant restoration of the muscle spindle's normal resting length, thereby helps to relieve the associated muscle spasm and possibly removes the fixation. This study was comprised of 30 subjects, all of whom were diagnosed with cervical facet syndrome. The subjects were randomly divided into two groups of 15 each with ap average age of24 years per group. The average male:female ratio was 1,1:1.