Determining Cavitation Location During Lumbar and Thoracic Spinal Manipulation
Bibliographic record
Abstract
STUDY DESIGN: Sixty-four asymptomatic participants, ranging in age from 22 to 49 years, volunteered to act as patients for the study. Twenty-eight different clinicians performed thoracic and lumbar spinal manipulative procedures. The range of clinical experience was 1 to 43 years. OBJECTIVES: The purpose of this study is to first locate the joints that produce an audible sound in response to manipulation (cavitation) during spinal manipulative procedures so that the accuracy and specificity of manipulation can be assessed. SUMMARY OF BACKGROUND DATA: Clinicians utilizing spinal manipulative therapy (SMT) claim to be very specific and accurate with the delivery of their dynamic thrust. It has been suggested that the clinical success of SMT is dependent on the accurate delivery of that therapy to the target spinal joints. METHODS: Asymptomatic participants received SMT to either the thoracic or lumbar regions of their spine. Accelerometers were secured to the skin over the spinal column, and the relative time at which each accelerometer detected the vibration from the cavitation associated with the SMT was used to calculate the source of the vibration. The site of cavitation was then compared with the target location. RESULTS: For lumbar SMT, the average error from target of 124 cavitations in lumbar procedures was 5.29 cm (at least one vertebra away from target), with a range of 0 to 14 cm. Of these cavitations, 57 were deemed to be accurate and 67 were deemed to be inaccurate. The average error from target of 54 cavitations in the thoracic spine was 3.5 cm, with a range of 0 to 9.5 cm. Of these cavitations, 29 were deemed to be accurate and 25 were deemed to be inaccurate. In most cases, individual manipulative procedures were associated with multiple cavitations ranging from 2 to 6. CONCLUSIONS: In the lumbar spine, SMT was accurate about half the time. However, because most procedures were associated with multiple cavitations, in most cases, at least one cavitation emanated from the target joints. In the thoracic spine, SMT appears to be more accurate.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".