Evidence for biomechanical changes in hypomobile intervertebral joints in SPECT (single photon emission computed tomography) bone scanning

Introduction: One of the most important tasks of manual therapists is the t reatment of hypomobile intervertebral joints. Such conditions of the spine are treated with various manipulations or mobilisation. The pathophysiologi cal basis of hypomobility is still under discussion. Objective criteria for the diagnosis of impaired spinal mobility are not available. Nor is any su bstrate detectable by X-ray, computed tomography or NMR. Aim: to find evidence of a biomechanical alteration of hypomobile intervert ebral joints with the aid of SPECT (Single Photon Emission Computed Tomogra phy). Study design: 13 outpatients with back pain but otherwise healthy att ending the Orthopaedic University Hospital in Marburg were examined by manu al medical means, and were found to have hypomobility of an intervertebral joint. In addition, the spines of these patients were examined with SPECT ( bone scanning). Results: Comparison of the results of physical examination and bone scannin g revealed that in 75 % of all the cases the location (spinal segment) of t he hypomobility identified by each of the two methods was identical. In 83 %, they were in agreement on which of the sides (facet joint) was affected.