Jonny Branney: An observational study of changes in cervical inter-vertebral motion and the relationship with patient-reported outcomes in patients undergoing spinal manipulative therapy for neck pain

Jonny Branney using quantitative fluoroscopy techniques to analyse spinal manipulation therapy’s effect on neck pain patients.

Researcher: Jonny Branney

For his PhD alongside BU’s School of Health and Social Care, Jonny (Jonathan) Branney is researching whether spinal manipulative therapy is associated with changes in the movement of the joints in the neck (cervical spine), and whether any such changes are related to patient-reported improvement. The study uses quantitative fluoroscopy (QF) which utilises low-dose motion x-rays to measure the movements of the vertebrae as a participant moves. The images are analysed using a bespoke computer program to     measure the movement between individual inter-vertebral levels.

The first stage of the project was to find out the accuracy of quantitative fluoroscopy (QF) using a model             constructed from two cervical vertebrae. Then, imaging sequences were obtained from a subgroup of people and analysed for intra-observer and inter-observer repeatability.

These two studies showed that QF was sufficiently accurate and repeatable (i.e. a repeated measurement gives a similar result) for the purposes of the main study.

For this part of the study, 30 patients with neck pain had their cervical motion at each inter-vertebral level          measured before and after treatment with spinal manipulative therapy, which was given over four weeks. They were also given questionnaires to measure any improvement in their neck pain.

30 matched healthy volunteers (who had no neck pain) also had two QF assessments four weeks apart, but         received no treatment. This allowed the comparison of both groups for any changes in motion at inter-vertebral levels in patients receiving manipulation with the natural variation in such motion determined from data from healthy volunteers.

Finally, any such changes are being explored in relation to changes in pain, disability, quality of life, global                improvement and satisfaction.

The statistical analysis is nearly finished and this PhD will represent the first study to actually measure in detail what neck manipulation does to inter-vertebral motion and whether the changes are related to patients getting better.


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