ABSTRACT
Objective To evaluate the rupture risk of carotid atherosclerotic plaque under cervical rotatory manipulation. Methods The fluid-structure interaction (FSI) model of carotid atherosclerotic plaque was established, and tensile deformation of the plaque and lumen under cervical rotatory manipulation was simulated.Mechanical parameters such as the maximum flow shear stress(FSS), the maximum wall shear stress (WSS), the maximum plaque wall stress (PWS), wall tensile stress (WTS) and wall pressure (WP) of the plaque and lumen were recorded. Results Under 16% carotid tensile deformation, the maximum WSS of the plaque was 40.54 Pa. The maximum PWS was 66.16 kPa, which was far smaller than the threshold of plaque rupture.The maximum WTS of fiber cap and the maximum strain were 156.75 kPa and 0.56, which were larger than the fracture strain range. The maximum WTS of the lumen was 1 040.30 kPa, which approached the threshold of medial membrane rupture and might cause vascular injury. Conclusions When the cervical spine rotates to the end range of motion, large carotid artery stretch may cause damage to epidermal tissues of the plaque, leading to abscission. Lesions, ulcers, bleeding and vascular damage may form inside the plaque, which will affect stability of the plaque. Cervical rotatory manipulation should be performed cautiously in patients with cervical diseases who also have carotid atherosclerotic plaques.The finite element assessment of plaques before manipulation may be an effective safety screening method.
ABSTRACT
Objective: To investigate the effects of cervical rotatory manipulation (CRM) on severe carotid atherosclerosis of rabbits in hemodynamics. Methods: Totally 40 New Zealand rabbits were divided randomly into 3 groups, including the manipulation group, the model group and the control group. Left carotid atherosclerotic plaques models were developed in the rabbits of manipulation group and model group. Then, the manipulation group was treated with CRM lasting for 2 weeks; meanwhile no intervention was given on rabbits in the model group and control group. At the end of manipulation, flow sheer stress (FSS) was calculated with velocity and viscosity of blood. One way AN OVA and LSR-t test were performed to explore the significance. Results: FSS of left carotid artery in rabbit decreased significantly in the manipulation group and the model group, in comparison with the control group. Moreover, FSS in the manipulation group was lower than that in the model group. Conclusion: FSS of severe atherosclerotic carotid artery in rabbit may become decreased following with CRM.
ABSTRACT
Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.
ABSTRACT
Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.
ABSTRACT
Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque. Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group, model control group and blank control group. Carotid atherosclerosis model were made in the experimental group and model control group. The experimental group received the intervention of cervical rotatory manipulation, but the model control group did not. The blank control group did not receive any intervention. After 3 groups received different interventions, the differences in tensile mechanical properties of rabbit carotid artery in three groups were observed. Results The ultimate strain, ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P<0.05); The ultimate strain in the experimental group was 24.87% and 52.09% smaller than that in the model control group and blank control group, respectively; The ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group, respectively; The physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group, respectively. Conclusions Compared with normal carotid artery, the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery, and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque. Therefore, for patients with carotid atherosclerotic plaque, it is better to avoid cervical manipulation.
ABSTRACT
Objective To explore the effect of cervical rotatory manipulation on tensile mechanical properties of carotid artery with atherosclerotic plaque.Methods Thirty healthy male New Zealand rabbits were selected and randomly divided into experimental group,model control group and blank control group.Carotid atherosclerosis models were made in the experimental group and model control group.The experimental group received the intervention of cervical rotatory manipulation,but the model control group did not.The blank control group did not receive any intervention.After 3 groups received different interventions,their differences in tensile mechanical properties of rabbit carotid artery were observed.Results The ultimate strain,ultimate load and physiological elastic modulus of rabbit carotid arteries in 3 groups were statistically significant (P ＜0.05);The ultimate strain in the experimental group was 24.87％ and 52.09％ lower than that in the model control group and blank control group,respectively;the ultimate load in the experimental group was 2.21 and 3.47 times of the model control group and blank control group,respectively;the physiological elastic modulus in the experimental group was 1.60 and 1.89 times of the model control group and blank control group,respectively.Conclusions Compared with normal carotid artery,the presence of carotid atherosclerotic plaque will reduce tensile mechanical properties of the carotid artery,and cervical rotatory manipulation will further reduce tensile mechanical properties of the carotid artery with carotid atherosclerotic plaque.Therefore,for patients with carotid atherosclerotic plaque,it is better to avoid cervical manipulation.
ABSTRACT
Objective To simulate the cervical rotatory manipulation(CRM)in flexion,neutral and extension positions using three-di-mensional finite element,so as to investigate the effect of this manipulation on the displacement and intra-stress of cervical disc in different positions.Methods By using the method of reverse engineering with Mimics 10.01,Geomagic Studio and Solidworks 14.0,a three-dimen-sional geometric CAD model of C5-6was developed from the CT scan images of a normal adult female aged 25 years.The model was import-ed into Ansys Workbench 14.5,and a three-dimensional finite element model was verified and simulated the CRM.The CRM was decom-posed by principium of manipulation in flexion,neutral and extension,respectively.The parameter of mechanics was analyzed with the fi-nite element system.The change of displacement and intra-stress distribution in cervical disc simultaneous were displayed during simulating the manipulation.Results The posterior part of opposite rotary side of annulus fibers was all retracted,and the displacement was toward an-terior,maximal in flexion position,followed as neutral position and minimal in extension position.In the meantime,the posterior part of the rotary side of annulus fibers was expanded into posterior,minimal in flexion position,followed as neutral position and maximal in extension position.The intra-stress in cervical disc was focused on posterior part of opposite rotary side,opposite rotary side and posterior part of the rotary side in flexion position,neutral position and extension position,respectively,maximal in flexion position,followed as extension posi-tion and minimal in neutral position. Conclusion To treat with cervical spondylotic radiculopathy in the perspective of safety of cervical disc,the CRM should rotate to the unaffected side,first in neutral position,second in flexion position if with poor efficacy.Patients with cer-vical spinal stenosis should not be treated with the CRM.
ABSTRACT
Objective To observe the clinical effect of the treatment of cervical spondylosis by the fixed rotation pulling method in the supine position.Methods 110 patients with cervical spondylosis met the inclusion criteria were selected as research objects,which were randomly divided into treatment group and control group,55 cases in each group,the treatment group were given fixed -point cervical rotatory manipulation in face -upward position, 1 times a day,3 times a week,1 weeks for 1 courses,the control group were received traditional massage treatment, 1 times a day,5 times a week,rest for 2 days,1 week for a course of treatment.both group had been treated for 2 courses, the cervical curvature were detected by borden,the cervical vertebra activity were detected by tape,then the effects were evaluated.Results The neck vertebral lordosis and activity degree of cervical flexion,extension,left rotation and right rotation,left and right flexion of the treatment group and the control group after treatment were significantly better than before treatment[(9.87 ±3.88)mm vs(6.75 ±3.40)mm,(3.22 ±1.16)mm vs (6.51 ±1.95)mm,(16.69 ± 1.49)mm vs (14.49 ±1.30)mm,(11.26 ±0.95)mm vs (14.07 ±1.16)mm,(11.59 ±1.28)mm vs (13.11 ± 1.71 )mm,(12.59 ±0.96)mm vs (13.02 ±1.14)mm,(12.09 ±0.91)mm vs (12.49 ±0.92)mm],the differences were statistically significant(t =6.226 and 3.558,5.554 and 3.408,4.702 and 3.382,5.003 and 3.605,7.004 and 3.882,5.036 and 3.554,4.818 and 3.588,all P <0.05).After treatment,the neck vertebral lordosis and Activity degree of cervical flexion,extension,left rotation and right rotation of the treatment group were significantly better than the control group,the differences were statistically significant(t =3.312,363.8,3.0338,3.251 and 3.422,all P <0.05).The effective rate of the treatment group was 96.3%,which of the control group were 81.8%,the difference was statistically significant(χ2 =11.444,P <0.05).Conclusion The fixed -point cervical rotatory manipulation in face -upward position has better effect than traditional massage in cervical type cervical spondylosis,which obvious advantages in improving the cervical physiological curvature and the activity,shortening the treatment time,to improve the clinical efficacy,which is worthy of clinical use.