Correlation analysis between position of head, cervical curvature classification and balance of cervical spine through lateral plain radiograph measurement / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the relationship between position of head, cervical curvature type and associated cervical balance parameters in a neutral looking-forward posture.</p><p><b>METHODS</b>Cervical lateral X-rays of 60 patients with cervical spondylosis were selected from January to December 2015. There were 22 males and 38 females with an average age of (35.5±10.9) years old. The measured parameters included cervical curvature type, McGregor slope, C2 lower end plate slope, T1 slope, center of gravity to C7 sagittal vertical offset (CG-C7 SVA), and C2 to C7 sagittal vertical offset (C2-C7 SVA). The parameters were analyzed using Spearman correlation.</p><p><b>RESULTS</b>The cervical curvature type was significantly correlated with C2 lower endplate slope, C0-C2 angle (total degree of C2 lower endplate slope plus McGregor slope), CG-C7 SVA and T1 slope (<0.05), but it was not significantly correlated McGregor slope (>0.05). C2 lower endplate slope and C2-C7 SVA (r=0.87) were significantly (<0.05) correlated with CG-C7 SVA (<0.05).</p><p><b>CONCLUSIONS</b>There was certain some relationship among position of head, cervical curvature type and associated cervical balance parameters in a neutral looking-forward posture. The center of gravity of the head would backwards shift following faced upward. A position of extension with posterior-shifting of the head would suggest that it may be accompanied with a relatively normal lordosis of the cervical spine. Some patients with abnormal curvature showed slightly bended head in the natural posture. Health education toward these people would be meaningful to restore the balance of their neck.</p>

Study on the clinical value of cervical spondylosis with articulatio atlantoepistrophica sublaxation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effect of articulatio atlantoepistrophica sublaxation on the pathogenesis of cervical spondylosis, and provide a thread for diagnosis and treatment of cervical spondylosis with manipulation.</p><p><b>METHODS</b>There were two groups in the study, which were non cervical spondylosis group and cervical spondylosis group. There were 333 patients in cervical spondylosis group, included 119 males and 214 females with the mean age of(48.11±12.21) years old. The patients were recruited from clinic service of orthopaedics in Shuguang Hospital between March 2006 and December 2008. There were 73 subjects in non cervical spondylosis group, included 18 males and 55 females with the mean of(45.99±11.47) years old. The subjects were recruited from undergraduate students, postgraduate, advanced study persons, and community personnel. The position relation of the atlanto axial joint was observed by cervical X rays with opening position, and the incidence rate of articulatio atlantoepistrophica sublaxation was compared between two groups, and their clinical characteristics were analyzed.</p><p><b>RESULTS</b>The incidence of articulatio atlantoepistrophica sublaxation in cervical spondylosis group was 81.38%(271/333)and was more than non cervical spondylosis group(<0.01). Furthermore, the pattern of the articulatio atlantoepistrophica sublaxation in cervical spondylosis group was complicated and diversified, which was 50.55% (137/271)with single moving sublaxation, 7.01%(19/271) with revolving sublaxation, 42.44%(115/271) with single moving and revolving sublaxation.</p><p><b>CONCLUSIONS</b>The articulatio atlantoepistrophica sublaxation may be a X ray diagnostic indication to the cervical spondylosis, which should be grouping studied in clinic. It will provide guidance for the diagnosis and treatment of cervical spondylosis.</p>

Understanding and diagnosis of "Gu Cuo Feng and Jin Chu Cao / 中国骨伤

Traditional Chinese Medicine believes that "Gu Cuo Feng and Jin Chu Cao "is the key pathogenesis for spinal degenerative disease, such as cervical spondylosis, but there is also lots of controversy for the concept of "Go Cuo Feng and Jin Chu Cao". The paper emphasizes the concept of "Cu Cuo Feng and Jin Chu Cao" from structural abnormality and dysfunction, and build the clinical standard of cervical "Gu Cuo Feng and Jin Chu Cao" from clinical symptoms, conventional physical signs of cervical spondylosis, special physical signs (mainly by palpation) and imaging measurement (special measuring method).

Study on the correlation between "Gucuofeng and Jinchucao" and cervical spondylosis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the relation between "Gucuofeng and Jinchucao" and cervical spondylosis.</p><p><b>METHODS</b>From March 2006 to October 2011,333 patients with cervical spondylosis were collected in the study as cervical spondylosis group; 30 subjects of control group come from student of Shuguang Hospital and other health volunteer. There were 119 males and 214 females with a mean age of (48.11 +/- 12.21) years in cervical spondylosis group and there were 6 males and 24 females with a mean age of (45.27 +/- 10.12) years in control group. In aspect of the symptom and sign, dynamic palpation, X-ray examination wer performed to find the incidence rate of "Gucuofeng and Jinchucao" in two groups.</p><p><b>RESULTS</b>There was significant difference in symptom and sign, dynamic palpation, X-ray examination between two groups (P<0.01). In cervical spondylosis group, "Gucuofeng and Jinchucao" occurred in 293 cases (87.99%),there was significant difference compared with control group (P<0.01).</p><p><b>CONCLUSION</b>Cervical "Gucuofeng and Jinchucao" is one of pathological point of cervical spondylosis,and it can provide a guidance for the diagnosis and treatment of cervical spondylosis.</p>

Clinical application of non-collinear spinous process in the diagnosis of cervical vertebra "Gu Cuo Feng and Jin Chu Cao" / 中国骨伤

<p><b>OBJECTIVE</b>To analyze value of X-ray in diagnosis of cervical vertebral rotation.</p><p><b>METHODS</b>From May 2010 to June 2011,129 patients with cervical spondylosis were collected and examined by X-ray. Among them, 119 cases were collinear spinous, other 10 cases were excluded with collinear. Of involved patients, 28 cases were male,91 cases were females with an average age of (48.53 +/- 14.32) (ranged, 24 to 65) years. The segments and numbers of vertebral body spinous process which were not centered were recorded, and then CT scan was performed to examine segments of vertebral body and spinous process which were not centered to observe rotation of cervical vertebra and spinous process deviation. The relationship between numbers of spinous not centered and vertebral rotation was statistical analyzed.</p><p><b>RESULTS</b>When the number of spinous not centered ranged from 1 to 6, vertebral rotation rate were 45.45%, 46.67%, 56.86%, 62.07%, 77.14%, 85.19% respectively.</p><p><b>CONCLUSION</b>The more numbers of vertebral spinous process not centered, the more chance of corresponding vertebral rotation.</p>

Close reduction combined with minimally invasive percutaneous plate osteosynthesis for proximal and distal tibial fractures: a report of 56 patients / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of close reduction combined with minimally invasive percutanous plate osteosynthesis (MIPPO) for proximal and distal tibial fractures.</p><p><b>METHODS</b>From March 2007 to December 2010, 56 patients with proximal and distal tibial fractures were treated with close reduction combined with MIPPO technique. There were 39 males and 17 females,aged from 22 to 67 years with an average of 41.3 years. Left fracture was in 25 cases and right fracture was in 31 cases; proximal tibial fracture was in 15 cases and distal tibial fractures was in 41 cases; 34 cases caused by fall down and 22 cases caused by road accident. The mean time from injury to operation was 1.7 d. Clinical manifestation included pain, swelling of leg with limitation of activity. According to the standard of Johner-Wruhs, clinical effects were evaluated.</p><p><b>RESULTS</b>The mean operative time was 46 min in 56 patients. All fractures obtained satisfactory reduction and the location of plate was good. Incisions healed with one-stage and no superficial or deep infection was found. All the patients were followed up from 8 to 23 months with an average of 14.2 months. Only one fracture complication with delayed union,and after auto grafting with ilium bone,the fracture got union. Other 55 cases obtained bone healing in 15 to 20 weeks after operation and no internal fixation failure was found. The time of walking was 4-6 months after operation,without limping at 7 months after operation. Both lower extremities were symmetrical and the function of knee and ankle got complete recovery. According to the criteria of Johner-Wruhs score,46 cases obtained excellent results,9 good and 2 fair.</p><p><b>CONCLUSION</b>Treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can not only preserve soft tissue,simplify operative procedure and decrease wound, but also can obtain rigid internal fixation and guarantee early function exercises of knee and ankle joints. The method has the advantages of less soft tissue injury, less blood loss, reliable fixation, which is effective method in treating proximal and distal tibial fractures and corresponds with the standpoint of biological fixation.</p>

Clinical significance of vertebral artery MRA to vertebral artery type of cervical spondylosis' diagnosis and treatment / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical significance of vertebral artery magnetic resonance angiography (MRA) to vertebral artery type of cervical spondylosis' diagnosis and treatment.</p><p><b>METHODS</b>There were two groups in the study, which were observation group and control group. There were 53 patients in observation group,including 19 males and 34 females,with a mean age of (52.51 +/- 11.29) years. There were 30 subjects in control group,including 10 males and 20 females,with a mean age of (48.11 +/- 12.21) years. Based on the vertebral artery MRA picture,the course and caliber of vertebral artery were compared between two groups.</p><p><b>RESULTS</b>The abnormal incidence of course and caliber of vertebral artery in observation group was higher than that of control group, which had statistic difference (P=0.000). Furthermore, the patterns of abnormal course and caliber of vertebral artery in observation group were complicated and diverse, but the regional circuity and stegnosis was the most common pattern,about 47.18%(25/53). The cause of circuity and stegnosis was vertebra Gu-Cuofeng,about 43.41% (23/53).</p><p><b>CONCLUSION</b>The vertebral artery MRA provides a guidance for the diagnosis of abnormal course and caliber of vertebral artery in vertebral artery cervical spondylosis.</p>

Retrospective analysis and prevention strategies for accidents associated with cervical manipulation in China / 中国骨伤

<p><b>OBJECTIVE</b>To review previously reported injuries cases which were associated with cervical manipulation in China, and to describe the risks and benefits of the therapy.</p><p><b>METHODS</b>Relevant case reports, review articles, surveys, and investigations regarding treatment of cervical spondylosis with cervical manipulation involving accidents and associated complication were retrived with a search of the literature from SinoMed, CNKI, CQVIP, and Wanfang digital databases between 1979 to March 2011. The data were extracted and statistically analyzed.</p><p><b>RESULTS</b>Total of 150 cases of injury reported in 40 articles corresponded the inclusion criteria. Accidents occurred in 156 cases,of them,syncope was in 45 cases (28.85%), mild spinal cord injury or compression was in 34 cases (21.79%), nerve root injury was in 24 cases (15.38%), ineffective or symptom increased was in 11 cases (7.05%); cervical spine fracture was in 11 cases (7.05%), dislocation or semiluxation was in 6 cases (3.85%), soft tissue injury was in 3 cases (1.92%), serious accident was 22 cases (14.70%, including paralysis, death and cerebrovascular accident). In cases of serious accident, 12 cases (54.55%) had the other primary diseases. Types of related manipulation including rotation reduction (42.00%, 63 cases), rubbing points or muscle resulting strong stimulation (28.00%, 42 cases). 100 cases (66.67%) obtained cured or basically recovered results, 21 cases (14.00%) improved, 4 cases (2.67%) deterioration and 5 cases (3.33%) died.</p><p><b>CONCLUSION</b>It is imperative for practitioners to complete the patients' management and assessment before manipulation. That the practitioners conduct a detailed physical examination and make a correct diagnosis would be a pivot method of avoiding accidents. Excluding contraindications and potential risks, standardizing evaluation criteria and practitioners' qualification, increasing safety awareness and risk assessment and strengthening the monitoring of the accidents could decrease the incidence of accidents.</p>

Enlightenment by chiropractic's developing mode / 中国骨伤

Traditional Chinese spinal manipulative therapy (TCSMT) and Chiropractic are similar in treating related with spinal disease, but they keep different characteristics of themselves. Although Chiropractic's "Subluxation" and TCSMT's "Jin Chu Cao and Gu Cuo Feng" theory have not be widely recognized, yet Chiropractic has already have official cooperation with WHO,and has launched "WHO Basis of Chiropractic Training and Security Guide" which would promote the project further research. Comparatively, TCSMT has mature theoretical system and satisfactory clinical effectiveness, but it's hard to global spreading formally and legally. By means of cogitation of the TCSMT'S basic theories and clinical applications, this paper aims to analyze the inadequacy aspects of it, and hope to borrow some Chiropractic's advantage to TCSMT's global spreading. And I wish this paper could be helpful for relative doctors and researchers.

Study on the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome based on the three dimensional finite element model / 中国骨伤

<p><b>OBJECTIVE</b>To study the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome using three dimensional finite element model.</p><p><b>METHODS</b>A patient with cervical spondylosis was randomly chosen, who was male, 28 years old, and diagnosed as cervical vertebra semidislocation by dynamic and static palpation and X-ray, and scanned from C(1) to C(7) by 0.75 mm slice thickness of CT. Based on the CT data, the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation (C(4)-C(6)). Based on the model,virtual manipulation was used to correct the vertebra semidislocation by the software, and the stress distribution was analyzed.</p><p><b>RESULTS</b>The result of finite element analysis showed that the stress distribution of C(5-6) facet joint and intervertebral disc changed after virtual manipulation.</p><p><b>CONCLUSION</b>The vertebra semidislocation leads to the abnormal stress distribution of facet joint and intervertebral disc.</p>

Systematic review of clinical randomized controlled trials on manipulative treatment of lumbar disc herniation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of the manipulative treatment on lumbar disc herniation and analyze the current status of clinical studies.</p><p><b>METHODS</b>The PubMed, OVID, Cochrane Library, CBM - disc database, CNKI database and VIP Database were retrieved, and 832 literatures on manipulative treatment for lumbar disc herniation were collected, in which 8 articles met the inclusion criteria. Cochrane systematic review was used to evaluate the quality; and RevMan 4.2 was used for Meta Analysis of Literatures.</p><p><b>RESULTS</b>There were total 911 patients in the 8 articles. The summary OR for the combined cure rate of the 8 articles was 3.65, and the 95% CI was [2.15, 6.20]. The summary OR for the combined efficiency was 3.56, and the 95% CI was [2.35, 5.38]. The cure rate and effective rate of the patients in manipulative group were superior to those of patients treated with other methods such as drugs, traction, acupuncture, microwave thermotherapy (all the methods were called as "other therapies").</p><p><b>CONCLUSION</b>This study shows that manipulative treatment on lumbar disc herniation is safe, effective, and both cure rate and the effective rate is better than other therapies. But the number of documents is limited and the quality is not very high, and the conclusion is still uncertain, high-quality evidence is needed to be further validated.</p>

Case control study on the association between abnormality curvature of cervical spine and pathogenesy of cervical spondylosis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the relationship between the abnormality curvature of cervical spine and pathogenesy of cervical spondylosis, in order to provide a new way in diagnosis of cervical spondylosis.</p><p><b>METHODS</b>There were two groups in the study, which were non-cervical spondylosis group (with heath adults) and cervical spondylosis group. From March 2006 to December 2008, 333 patients (out-patients in department of orthopaedics of Shuguang hospital) in cervical spondylosis group, which were 119 males, 214 females with an average age of (48.11 +/- 12.21) years. There were 73 subjects in non-cervical spondylosis group, which was 18 males, 55 females with an average age of (45.99 +/- 11.47) years. Based on the lateral view X-ray pictures of cervical spine, the abnormality curvature and character of cervical spine were studied in two groups.</p><p><b>RESULTS</b>The incidence rate in abnormality curvature of cervical spine in cervical spondylosis group (achieved to 95.50%) was more than that of non-cervical spondylosis group, there was significant difference between two groups (P = 0.000 < 0.01). Furthermore, the patterns of the abnormality curvature of cervical spine in cervical spondylosis group was complicated and variegated, of which physiological curvature diminished had 23.12% (77 cases), turn straight had 40.84% (136 cases), increased had 0.60% (2 cases), recurved had 12.01% (40 cases), S shape had 4.20%(14 cases), contra-S shape had 2.70% (9 cases), upper flex and lower straight had 4.50% (15 cases), upper straight and lower flex had 7.51% (25 cases).</p><p><b>CONCLUSION</b>The abnormality curvature of cervical spine may be an X-ray diagnostic indication to the cervical spondylosis, which is complicated and variegated. It will provide the guidance for the diagnosis and treatment of cervical spondylosis.</p>

Study on the method of construct the three-dimensional finite element model of cervical vertebrae semidislocation / 中国骨伤

<p><b>OBJECTIVE</b>Cervical vertebra semidislocation was one of major pathological aspects of cervical spondylosis, and it was also the target of manipulation to treat cervical spondylosis. The aim of this study was to combine the technology of three dimensional finite element analysis to investigate the method to construct the cervical vertebra semidislocation model.</p><p><b>METHODS</b>A cervical spondylosis patient (male, 28 years old,176 cm tall, weight 69 kg) was randomly chosen, who was diagnosed cervical vertebra semidislocation by dynamic and static palpation and X-ray,and CT scanned from C1 to C7 by 0.75 mm slice thickness. Based on the CT data, the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation (C4-C6).</p><p><b>RESULTS</b>The model showed the three dimensional changes of vertebra semidislocation clearly. C5 had a three-dimensional abnormal position, which was downward translation for 0.9 mm and clockwise rotation for 4.5 degrees around X-axis. So C5 was diagnosed as hypokinesis-type semidislocation.</p><p><b>CONCLUSION</b>The method to construct the three dimensional finite element model of cervical vertebra semidislocation is reliable, which provide a base study to analyse the mechanism of manipulation to treat vertebra semidislocation.</p>

Diagnosis and treatment of intervertebral disc disease based on the theory of "Gucuofeng and Jinchucao" / 中国骨伤

It has previously been reported that the incidence rate of intervertebral disc disease including cervical and lumbar vertebra is at the 8th position among the chronic and difficult treated diseases in China. There are great challenges on the improving diagnosis and treatment as well as reducing recrudescence of this degenerative disease. It was well known that the degeneration and bulge or herniatation of intervertebral discs are the main reasons for it, and the treatment for it always focuses on the disc recovery. However, the discrepancy of the effect and expectation indicated that there were other reasons for it. Based on the clinical knowledge of intervertebral discs disease and combined with the cognition of Traditional Chinese Medicine,we proposed that the pathogenesis of intervertebral disc disease was Gucuofeng and Jinchucao, which meant that the improper location of diapophysis and the declined of muscle strength may cause the unstable of spine, unstable spine thus aggravated the semiluxation of diapophysis.