The Clinical And Basic Study Of Cracking Sounds Made By Cervical Rotatory Manipulation

Cervical rotatory manipulation is a usual non-surgery method of treatment forcervical disease. There are some kinds of rotatory manipulations, but the mostfrequently used ways are cervical rotatory and local manipulation and cervicalrotatory and local manipulation. If we know the difference of curative effect oncervical disease between the rotarory and local manipulation and lifted and rotatorymanipulation, and the facet joints' location of cracking sounds caused by cervicalrotatory manipulation, then we can know the exact location of manipulation's effecton. It's very good for promoting the accuracy and curative effect of manipulation. Inthis study, we compare the curative effect on cervical spondylotic radiculopathy ofcervical rotatory and local manipulation with that of cervical lifted and rotatorymanipulation. And we design a set of equipment to collect, locate and analyze thecracking sounds during cervical rotatory and local manipulation, so we can locate thecracking sound. The study is divided into 3 parts.1 The comparison of two kinds of cervical spinal rotatory manipulations'effect on cervical spondylotic radiculopathy(1)Objective To study the differences of curative effects on cervical spondyloticradiculopathy between the cervical rotatory and local manipulation and lifted and rotatory manipulation.(2)Methods 30 cases of cervical spondylotic radiculopathy patients were dividedinto two groups. The treatment group were performed rotatory and local manipulationfor a course of treatment, and the control group were performed lifted and rotatorymanipulation for a course of treatment too. And we design a assessment scale ofcurative effect on cervical spondylotic radiculopathy according to the patients'subjective symptom, clinical examination and daily living action. We score beforeand after treatment respectively. Then we have the data statistical analysis.(3)Results There is significant difference between post and prior-treatmentscore of symptom and physical sign in treatment group (P＜0.001), at the same timethere is significant difference between post and prior-treatment score of symptom andphysical sign in control group too (P＜0.001). But the difference of post andprior-treatment score of symptom and physical sign in treatment group is much morethan that in control group significantly, there is significant difference too(P＜0.001).(4)Conclusion The two kinds of manipulations both make obviousimprovements in symptom and physical sign of patients with spondyloticradiculopathy. But the effect of the cervical rotatory and local manipulation is muchbetter than that of the cervical lifted and rotatory manipulation.2 Measurement technique for the cracking sounds during spinalmanipulation(1)Objective To design a set of equipment to collect, locate and analyze thecracking sounds during spinal manipulation.(2)Methods On the basis of reviewing the current techniques for cracking soundmeasurement, we designed a cracking measurement system consisting of a pulsegenerator, transmission/reception interface calibrating wave generator, compoundsensors, computer, analytical software and output components. (3)Results Preliminary experiments demonstrated that the cracking sounds couldbe detected at a distance of 40m.(4)Conclusion This device can be used for collecting, locating and analyzing thecracking sounds during spinal manipulation.3 Study on the location of cracking sounds by cervical rotatory and localmanipulation(1)Objective To detect the facet joints' location of cracking sounds caused bycervical rotatory and local manipulation.(2)Methods 30 healthy adults were performed cervical rotatory and localmanipulation which were located at the spinous process of C₄ each on left and rightside, at the same time, a set of equipment devised by ourselves was applied to collectand locate the cracking sounds, and made statistical analysis.(3)Results The cracking sounds caused by cervical rotatory and localmanipulation mainly localized at C_3-7 facet joints, and the times of cracking sounds ofthese facet joints had significant differences with those of the other facet joints.(4)Conclusion The location of cervical rotatory and local manipulation is notaccurate but inexplicit.At last, it takes a conclusion to the whole thesis and analyze the innovation andlimitation of the study. There is a suppose on the further research following the thesisand propose to the further study:At last, it takes a conclusion to the whole thesis and analyze the innovation andlimitation of the study. There is a suppose on the further research following the study:(1)We design a assessment scale of curative effect on cervical spondyloticradiculopathy according to the patients' subjective symptom, clinical examination anddaily living action, which can compare the patients' condition of prior-treatment withthat of post-treatment condition quantitatively and objectively. But it is subjective when judging the therapeutic efficacy.(2) In order to study the dose-effect relationship of cracking sounds andmanipulative force easily, we should boost the sample frequency of sound collectingsystem, improve the technique of detection and the analytical method, and we shouldmix other testing techniques together.(3)The test of cracking sounds location is just on the basis of healthy people, weshould progress more studies on patients with cervical syndrome. Otherwise, is theredifferent testing result if we locate on different cervical spinous process duringmanipulation? is there any limitation if we collect the homolat maximum sound whenthere are many sounds during manipulation? Is there any rule of cervical rotatory andlocal manipulation to detect? We should progress more study on these questions.