Effect of manipulative therapy on blood flow velocity in vertebrobasilar arteries of patients with cervical spondylosis and abnormal curvature

Jian WEI; Guikang WEI; Rong HUANG; Binbin ZHOU

ABSTRACT

BACKGROUND:

Abnormal curvature of the cervical spine reflects in large measure the degenerative changes of the cervical vertebrae.

OBJECTIVE:

The effect of manipulative therapy has been recognized in restoring normal cervical curvature, and aimed to further probe into the effect of this therapy on blood flow velocity in the vertebrobasilar arteries of patients with cervical spondylosis.

DESIGN:

A non-randomized and controlled concomitant study.

SETTING:

Departments of Spinal Orthopaedics and General Sugery of a University hospital, and the Outpatient Department of Orthopaedic Institute of a college of Traditional Chinese Medicine. PARTICI PANTS From January 1999 to December 2001, 60 patients with cervical spondylosis were treated in the Department of Spinal Orthopaedics in Ruikang Hospital, Third Department of Surgery, First Affiliated Hospital of Guangxi College of Traditional Chinese Medicine, and Outpatient Clinic of Institute of Orthopaedics, Guangxi College of Traditional Chinese Medicine. The patients were divided into spondylosis group with abnormal curvature(30 cases) and spondylosis group without normal curvature(30 cases) . Thirty healthy subjects were also included to serve as the control group.

METHODS:

Manipulation was applied in these patients and the cervical curvature and blood flow velocity in the left vertebral artery (LVA) and right vertebral artery(RVA) as well as in the basilar artery(BA) were measured before and after the treatment for comparison. The correlation coefficients between them were also calculated.MAIN OUTCOME

MEASURES:

① The cervical curvature before and after manipulation in spondylosis group and control group; ② The blood flow velocity in maximal systolic phase and end-diastolic phase in the specified arteries.

RESULTS:

The blood flow velocity in maximal systolic phase and end-diastolic phase decreased in LVA, RVA and BA in patients with abnormal cervical curvature, whose blood velocities in maximal systolic phase in these arteries was less than those in control subjects and patients with normal curvature ( P ＜ 0.05). After manipulation, the velocity in these arteries in creased apparently in patients with abnormal curvature. The changes in systolic velocity in LVA and systolic in BA were correlated to the curvature before manipulation, and after that, the maximal systolic velocity in LVA,maximal systolic velocity in RVA and BA were all related to the changes of the cervical curvature.

CONCLUSION:

Abnormal cervical curvature is the anatomical basis for abnormalities of the vertebrobasilar arteries. Manipulative therapy can restore the cervical curve and blood flow velocity in these arteries.