Thoracic spine side-bending

Type I and type II dysfunctions refer only to somatic dysfunctions in the thoracic and lumbar vertebrae because Fryette s principles only apply to these areas. However, in common usage, somatic dysfunctions in the typical cervical spine are often referred to as type II, Motion characteristics of the cervical region dictate that the typical cervical vertebrae side-bend and rotate toward the same side regardless of dysfunction or normal functioning. The distinction is the involvement of a flexion or extension component in the dysfunctional unit. 

Harrison Fryette, in Principles of Osteopathic Technique, discussed specific coupled motion patterns. Of relevance here, when the spine is at rest, normal lateral flexion in one direction will cause the vertebral body to rotate in the opposite direction. (This rule apphes oidy to the thoracic and lumbar regions.) If a group of vertebrae side-bend toward the right, the vertebral bodies will... 

Figure 39-1 shows the locations of the anterior tender points for the thoracic spine. All anterior tender points are treated with flexion as the major movement in positioning. Fine-tuning of the position will be by side-bending and/or rotation. 

Thoracic spine forward bending, backward bending, rotation, side-bending. 

Scoliosis is an abnormal lateral ciuvature of the spine lying in the coronal plane. The thoracic spine is especially prone to development of scoliosis or kypho-scoliosis (side-bending of the spine with an excessive flexion of the spine). Scoliosis can be generally classified irrto two major types ... 

Another method for assessing the ability of the lumbar spine to side-bend without a significant contribution from the thoracic spine is the hip drop test. The patient is standing with his weight equally distributed and his feet 4 to 6 inches apart. The physician stands behind the patient with his eyes relatively level with the lumbar region. He may kneel or squat to do so. 

Normally, the lumbar spine is convex on the side of the short leg as the spine side-bends back toward the midline. Occasionally, a compensatory curve will develop in the thoracic spine in the opposite direction from that in the lumbar spine. Sacral base leveling with straightening of the spinal curvature is the goal of therapy. 

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