旋转手法治疗椎动脉型颈椎病的应用解剖及流体力学研究

Hydromechanics and applied anatomy for the treatment of the cervical spondylosis with the vertebral artery type using rotation manipulation

目的 为旋转手法治疗椎动脉型颈椎病提供应用解剖学基础及流体力学研究资料。方法 在 3 1具成人尸体标本上对颈椎、椎动脉进行观察和测量并在选取的 2具新鲜成人尸体标本上进行流体力学实验研究。结果 ①两侧椎动脉间距在C2 处最大 ,C5处最小。②椎动脉与C2 ,3椎间盘外侧缘的距离最大。③颈椎横突孔高度 :C5、C6 >C2 、C3,C6 >C4 >C3;上下颈椎横突孔间距 :C1,2 >C2 ,3、C3,4 、C4 ,5、C5,6 。④各颈椎间盘厚度 :C5,6 、C6 ,7>C2 ,3、C3,4 ,C5,6 >C4 ,5。⑤前屈位致双侧椎动脉引流管滴数减少。旋转颈椎超过一定角度时 ,双侧椎动脉引流管滴数出现下降 ,至旋转极限时 ,甚至完全停止。结论 旋转手法对C1、C2 、C3发病部位疗效较好 ,对下段颈椎病变、双侧椎动脉均发生病变等情况 ,手法方式要进行适当调整 。

Objective To provide applied anatomy basis and hydromechanics data for treatment of the cervical spondylosis with the vertebral artery type (CSA) with rotation manipulation Methods The cervical vertebrae and vertebral artery (VA) in 31 adult cadavers were observed and measured.Two fresh samples of them were selected for study of the hydromechanisc.Results ①The distance between both is the largest in C 2,and smallest in C 5.②The distance from VA to the lateral border of C 2,3 intervertebral disc is the largest.③The height of the transverse foramen is C 5?C 6>C 2?C 3,C 6>C 4>C 3.The distance from upper transverse foramen to lower one is C 1,2>C 2,3?C 3,4?C 4,5?C 5,6.④Cervical disc thickness is C 5,6?C 6,7>C 2,3,C 3,4,C 5,6>C 4,5.⑤Antefleixion of the cervical vertebrae lead to the decrease of the dropping amount of drainage tubes of both VA.The dropping amount of drainage tubes of both VA decreases at the certain degree of the vertebral rotation,even stops at the maximum rotation.Conclusion The rotation manipulation was helpful to treat pathological changes in C 1?C 2?C 3.However,it should be adjusted properly when the pathological changes took place in the both sides of VA and the lower cervical vertebrae.The strong manipulation with large rotation should be avoided.