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76 SEGION II CLINICAL OBSERVATIONS AND ADVANCED AsSESSMENT PROCEDURES

before other anatomical structures are addressed. As was previously noted by Panjabi, three systems contribute to lumbopelvic
stability: a passive subsystem, an active subsystem, and a neural control subsystem. In my opinion, leg length reactivity analysis
involves the interaction between at least two of these systems-active and neural control-which in turn involves the passive
subsystem and includes nociceptive pain sensors from inflamed passive structures.
Panjabi's theoretical spinal stability system model can also serve as a theoretical model proposed to explain neuroarticular
dysfunction. However, the somatic-visceral component of the subluxation complex is not included in this model and can play a
significant role. Let's look at two of Panjabi's figures. The first schematic represents the theoretical model for a normally
functioning stabilizing system. The goal is to provide sufficient stability to the spine to match the instantaneous varying stability
demands produced by changes in spinal posture and static and dynamic loads. The three subsystems work together to achieve the
goal.
As shown in [Figure 5-4], the information from the ( 1 ) passive subsystem sets up specific (2) spinal stability requirements. Consequently,
requirements for (3) individual muscle tensions are determined by the neural control unit. The message is sent to the (4) force generators.
Feedback is provided by the (5) force monitors by comparing the (6) "achieved" and (3) "required" individual muscle tensions.10
The passive (ligamentous) subsystem provides little stability to the spine when it is near

0
the neutral posmon. It is at the end of the ranges of motion that the ligaments develop reactive forces to resist spinal motion. "The
passive components probably function in the vicinity of the neutral position as transducers (signalproducing devices) for
measuring vertebral positions and motions, similar to those proposed for knee ligaments,74 and therefore are part of the neural
control subsystem. Thus this subsystem is passive only in the sense that it by itself does not generate or produce spinal motions,
but it is dynamically active in monitoring the transducer
signals.,,75
As is shown in the schematic (see Figure 5-4), the active musculotendinous subsystem is the means through which the spinal
system generates forces to provide stability to the spine. The magnitude of the force that is generated by each muscle is measured
by the neural control subsystem through force transducers built into the tendons of the muscles. Information from the transducers
is relayed to the neural control subsystem so that specific requirements for stability control can be determined. The tension of
individual muscles is measured and adjusted and is dependent on dynamic posture and variation in lever arms and inertial loads
of different masses and external loads. Deformation of ligaments throughout the neutral zone involves a large neuronal
component. Soft tissues deform under spinal loads and are capable of providing a comprehensive set of signals from which
stability requirements may be determined.
Panjabi's theory as illustrated above was confirmed in a study by Solomonow et al. (published in 1998). 1 9 It was confirmed that
the supraspinal

'1 J Spinal stability requirement I


0) 0) 0) It
Individual
Required
muscletensions
Transducers Force
monitor generators

motion loads Position (s) � t � Force


Individual muscle
Achieved
tensions
monitors
Figure 5-4 Fadors and feedbacks in the stabilizing system. (Modified from Panjabi MM. The stabilizing system of the spine. Part
II. Neutral zone and stability hypothesis. J Spinal Disord /992,5[4]:390-7)

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