7 - Vertebral Artery Variants’ Potential Risks in Osteopathic Manipulative Treatments

Poster Board Number: 7
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Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : Vertebral artery (VA) variants have been well-documented in the literature; however, their frequency in the United States population of donors has yet to be investigated. There are documented cases of vertebral artery dissections and insufficiencies based off different cervical manipulations. Examination of VA variants as well as a literature search about the osteopathic consequences of these variants led to an investigation of: do these variants pose a risk to harming patients that receive Osteopathic Manipulative Treatment (OMT)? Do these variants cause too much strain on the vasculature during treatment? Do these variants add to the probability of VA dissection? The literature examines the lengths, level of origins and entrances for VA variants, however more information about the effect of these differing attributes on OMTs is still needed. Currently, the VA can be assessed using the Extension Rotation Test in OMT. This test involves cervical spine motion to an end-range position of rotation, extension, or a combination of both. This test indicates insufficient blood flow in the VA assessed but it does not test the threshold strain of the VA being elongated during the technique. However, this test has low specificity and sensitivity about the morphology of the VA and the implications of this morphology. Examining Ohio University donors suggests that VA variants are under significant strain, especially ones that are shorter in length and smaller in diameter. These potential strains on these variants could result in a fair amount of stress even with slight movement into OMT positioning. In addition, this could potentially mean that the probability of VA dissection is also increased with manipulation. The significance/implication of this investigation is that it could better understand the effects of osteopathic manipulation on anatomic variants. Overall, this can help physicians to prescreen and treat patients more effectively before OMT to account for any VA variation they may possess.