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A Question of Ethics
Recently, after I had finished teaching a class on ethics, I  read a blog post on the AAAOM
website regarding "gainful employment." The published information made me reflect on what I had just discussed with the students — the acupuncturists' ethical responsibility to the patient, the profession and the public.
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Chiropractic Research Review

Possible Mechanisms of Neurovascular Compression

Signs and symptoms of neurovascular compression may manifest when degenerative tissues encroach on the spinal cord or nerve roots. Neurovascular compression within the spinal and intervertebral canals has been attributed to several causes, including degenerative changes, pathology, and axial loading, leading to stenosis.



In a study designed to describe the possible causes of encroachment on human spinal and intervertebral canal (foramen) neurovascular structures, researchers reviewed imaging films from patients (38-52 years old) and histopathologic sections from cadavers (40-60 years old).

Results:

* Various bony and soft tissue structures may be responsible for stenosis of the spinal and intervertebral canal.

* Stenosis may be related to osteophytosis of the vertebral body, unconvertebral joints and zygapophysial joints.

* Other potential causative factors for stenosis include intervertebral disc protrusion, ossification of the posterior longitudinal ligament, and ligamentum flavum hypertrophy or buckling.

Conclusion: Various forms of spinal and intervertebral canal stenosis can cause neurovascular compression leading to overt symptomatology. Mechanisms of neurovascular compression must be considered in light of existing pathology and possible functional pathology. This knowledge can help clinicians "...successfully explain to patients why they have spinal pain syndromes" when spinal and intervertebral canal stenosis are present.

Giles LGF. Mechanisms of neurovascular compression within the spinal and intervertebral canals. Journal of Manipulative and Physiological Therapeutics, Feb. 2000:23(2), pp107-11. Reprints: Tel: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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