Bourdillon's Spinal Manipulation THIS PAGE INTENTIONALLY LEFT BLANK Bourdillon's Spinal Manipulation SIXTH EDITION EDWARD R. ISAACS, MD, FAAN Associate Professor of Neurology, Virginia Commonwealth University School of Medicine, Richmond; Clinical Associate Professor of Neurology and Osteopathic Manipulative Medicine, Michigan State University College of Osteopathic Medicine, East Lansing MARK R. BOOKHOUT, MS, PT Clinical Associate Professor of Physical Medicine and Rehabilitation and Osteopathic Manipulative Medicine, Michigan State University College of Osteopathic Medicine, East Lansing; President, Physical Therapy Orthopaedic Specialists, Inc., Minneapolis UTTERWORTH E I N E M A N N Boston • Oxford • Auckland • Johannesburg • Melbourne • New Dehli Copyright c 2002 by Butterworth-Heinemann & A member of the Reed Elsevier group All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in :lOy form or by any means, electronic, mechanical. photocopying, recording, or otherwise, without the prior written permission of the publisher. Every effort has been made to ensure that the drug dosage schedules within this text are accurate and conform to standards accepted at time of publication. However, as treatment recommenda­ tions vary in the light of continuing research and clinical experience, the reader is advised to verify drug dosage schedules herein with information found on product information sheets. This is espe­ cially true in cases of new or infrequently used drugs. Recognizing the importance of preserving what has been written, Butterworth-Heinemann prints its books on acid-free paper whenever possible. Library of Congress Cataloging-in-Publlcation Data Isaacs, Edward R., 1943- Bourdillon's spinal manipulation / Edward R. Isaacs, Mark R. Bookhout.-6th ed. p.; cm. Rev. ed. of: Spinal manipulation / J.F. Bourdillon, E.A. Day, M.R. Bookhout. 5th ed. 1992. Includes bibliographical references and index. ISBN 0-7506-7239-0 1. Spinal adjustment. I. Title: Spinal manipulation. II. Bookhout, M.R. III. Bourdillon. J.F. Spinal manipulation. IV. Title [DNLM: 1. Back Pain-therapy. 2. Manipulation, Spinal-methods. 3. Osteopathic Medicine-methods. WB 940 I73b 20011 RZ399.S7 B6 2001 615.5"03-dc21 British Ubrary Cataloguing-in-Publication Data A catalogue record for this book is available from the British library. The publisher offers special discounts on bulk orders of this book. For information, please contact: Manager of Special Sales Butterworth-Heinemann 225 Wildwood Avenue Woburn, MA 01801-2041 Tel, 781-904-2500 Fa., 781-904-2620 00-067476 For information on all Butterworth-Heinemann publications available, contact our World Wide Web home page at: http://www.bh.com 10 9 8 765 4 3 2 1 Printed in the United States of America In memory of John F. Bourdillon, FRes, FReSe THIS PAGE INTENTIONALLY LEFT BLANK Contents Preface to the Sixth Edition ix Preface to the First Edition xi Acknowledgments xiii 1. Introduction 1 2. Anatomy and Biomechanics 9 3. Examination: General Considerations 35 4. Detailed Examination: The Pelvis 61 5. Detailed Examination: The Spine 85 6. Manipulation 111 7. Treatment of Dysfunctions of the Pelvis 125 8. Treatment of the Lumbar Spine 157 9. Treatment of the Thoracic Spine 185 10. Diagnosis and Treatment of Dysfunctions of the Rib Cage 207 11. Treatment of the Cervical Spine 237 12. The Lumbosacral Junction and an Overview 253 of Treatment Strategies for the Spine 13. Pain Patterns and Musculoskeletal Dysfunction 271 14. Examination and Treatment of Muscle Imbalances 283 15. Exercises as a Complement to Manual Therapy 301 Index 315 vii THIS PAGE INTENTIONALLY LEFT BLANK