Clinical Effect Of Acupotomy Combined With Supine Reduction Manipulation In The Treatment Of Atlantoaxial Subluxation

Objective:To observe the clinical efficacy of acupotomy combined with subluxation manipulation in the treatment of atlantoaxial subluxation,summarize and analyze the advantages and disadvantages of manual treatment,acupotomy treatment and the combined treatment,and explore the effective conservative treatment of atlantoaxial subluxation.Methods:Ninety atlantoaxial subluxation patients were selected and divided into three groups using the random number table method in the ratio of 1:1:1.30 patients in the manipulation group were treated with atlantoaxial repositioning after relaxation by manipulation.30 patients in the acupotomy group were treated with acupotomy therapy.And in the combined group,acupotomy was performed after manual relaxation,and atlantoaxial manipulation was performed after reduction.The Rotating Rngle of Rtlas on Dentate(RAAD),the Variance of Bilateral Lateral Atlanto Dental Space(VBLADS),the Atlas Dens Interval(ADI),the Variance of Bilateral Lateral Mass Interval(VBLMI),the Visual Analogue Scale for Pain(VAS)and the Evaluation Scale for Cervical Vertigo(ESCV)were recorded before and after treatment.The data were analyzed by SPSS 26.0 statistical software.Result:1.Comparison of basic data:Basic data such as gender,age,course of disease,VAS score before treatment,ESCV score and imaging indicators of the three groups were statistically analyzed,and the result was P>0.05,which was not statistically significant,meeting the requirements of comparability.2.Comparison of observation indicators:VAS scores,ESCV scores and imaging indicators were compared before and after treatment in each group,and the result was P<0.05,which was statistically significant.The data of the three groups were compared between the three groups,and the result was P<0.05,the difference was statistically significant.Among them,the comparison result between the acupotomy group and the manipulation group was P>0.05,the difference was not statistically significant;the comparison result between the combination group and the manipulation group was P<0.05,the difference was statistically significant;the comparison result between the combination group and the acupotomy group was P<0.05,the difference was statistically significant.3.Comparison of effective rate:The treatment effective rate of the three groups was compared between groups,and the result was P<0.05,the difference was statistically significant.Among them,the comparison result between the acupotomology group and the manipulation group was P>0.05,the difference was not statistically significant;the comparison result between the combination group and the acupotomology group was P<0.05,the difference was statistically significant;the comparison result between the combination group and the manipulation group was P<0.05,the difference was statistically significant.Conclusion:1.Manual therapy,acupotomy,and a combination of the two for non-traumatic atlantoaxial subluxation in adults have all shown good results in improving the clinical symptoms and imaging indices of the patients;2.Acuotomy makes up for the disadvantage that it is difficult to completely relax the tense muscles and soft tissues of the neck in a single manipulation operation,and corrects the abnormal stress of the neck to a large extent in a short time.Manual reduction accelerates the process of joint structures returning to normal anatomical position after acupotomology treatment,so that the recovery of dislocated structures no longer only depends on the tissue pulling after the normal mechanical balance.3.The combination of acupotomy and manipulation was more effective than the single use of manipulation or acupotomy,and the combined group achieved better results in terms of clinical manifestations and imaging indices.