Accuracy of the palpatory procedure of the spinous process of the seventh cervical vertebra

Abstract

Introduction: In the physical exam of the cervical spine, the palpatory anatomy is one of the most important procedures in identifying and localizing musculoskeletal disorders. Furthermore, it is the basis of specific techniques in some treatments. In the other hand, there is a large bias in accuracy and reproducibility of studies. There is a lack of research in the area and few articles propose a systematic analysis of cervical vertebrae palpation, especially the influence of mobility test in accuracy associated anthropometric aspect as weight, length, body mass index (BMI) and age. Objectives: To evaluate the accuracy of motion palpation procedure (Test flexion and extension) to the location of the C7 spinous process; determine the margin of error palpation of the spinous process of C7; determine the possible relationship between the accuracy and the independent variables: height, weight, age, gender and BMI, as well as the dependent variable: coincidence between the most prominent vertebra and the determination of probable thorny C7, the Flex Test and Extension and determine the relationship between palpation error and the independent variables and dependent aforementioned Methods: This cross-sectional study analyzed 101 adult subjects, of both genders, where a metal marked was used to identify C7 spinous process according to Flexion and Extension test and confirming by X-Ray exam. Subject characteristics were analyzed through descriptive statistic. The relation between dependent and independent variables were obtained by logistic regression as a significance level of 95% (p≤ 0, 05). Results: Among participants 48.5% men as range of age 56.8 years (SD ± 14.9) and BMI range of 25.54 kg/m2 (SD ± 5.5). Referring to the correct answers, in 54.5% of cases occurred the correct identification C7 spinous process. There were 45.5% systematic errors as a prevalence of localization in C6 of 60, 9%. The coincidence of the most prominent stationary vertebrae (C7) through the Flexion and Extension Test and the correct localization analyzed by X-Ray was significance (p=0,021). About the relation between BMI and the correct identification, our findings showed to a significance relation (p=0, 05). Conclusion: The location of the C7 spinous process becomes more accurate in patients with BMI ≤ 25 and whose most prominent location of the vertebra make coinciding with the location of the stationary vertebra (C7) determined by Flexion and Extension Test.