Security-related Factors Of The Neck Pull Method

Objective:There is a growing tendency for Cervical diseases because of modern life-styles, and a lot of the Cervical diseases can be treated with Anmo-Tuina. As the main and commonly-used one of the reducing dislocted manipulations, Ban-Manipulation is effective for dysfunction and dislocation of joints, so Neck ban-manipulation has a plenty of space to expand in clinical application. However, statements about Neck ban-manipulation are so many and different with each other that it is necessary to sum up them so as to guide clinical operation further.Based on clinical application, the research intend to search out similarities and differences,application and security of all the Neck ban-manipulation by summarizing and analyzing literature, so as to provide a certain theory support for clinical operation.Method:By collecting statements on name and operation of Neck ban-manipulation in different textbooks and articles, the research means to find out similarities and differences among them, so as to analyze and summarize aspects relative to security.Choose textbooks approved and used by universities of traditional Chinese medicine, and then collect statements of process and main aspects during operation,matters need attention, effects and so on, finally analyze and summarize the manipulations.Consult literature in the CNKI with ban-manipulation as the search key, then consult in the result with cervical vertebra as the search key, in the end 503 articles published during recent years were obtained. Read them and those ones which were published in core journal or professional Chinese Anmo-Tuina journal were picked out, finally 214 articles were confirmed in the research. Conclusion is based on sorting out the 214 articles, analyzing process and main aspects during operation,matters need attention,effects, and typical cases either effective ones or accidents reported recent years.Discussion and Results:1. Ban-manipulation can be divided into two kinds by whether with location or not. Ones without location is effective in adjusting intervertebral space,relaxing joints and relieving muscle spasm, while the other ones with location can regulate abnormal anatomic location, restore dislocated joints, so as to relieve symptoms caused by dislocated joints.2. Ban-manipulation also can be divided into two kinds by direction: Rotational ban-manipulation and Side ban-manipulation. The word"rotational"means head of patient is rotated during the operation, while Side ban-manipulation is mainly directed towards lateroflexion dysfunction.3. Aspects of each Ban-manipulation including are: location,rotation,flexion and extension,lateroflexion,occasion and method of manipulation,traction or not and body position.Location refers to finding out and fixing at the abnormal cervical vertebra with the help of inquiry,palpation and X-ray; Rotation aims at finding out the abnormal cervical vertebra, as well as taking advantage of rotation inertia to carry out the manipulation; flexion and extension can be helpful in relieving muscle spasm; Lateroflexion could broaden inter- -vertebral space of the opposite side, and increase the Lateroflexion degree; When the patient relaxes, the patient's head has been rotated or turned to one side to the maximum extent, the doctor rotates or turns the patient's head quickly but gently to a further small amplitude,utilizing the shearing force caused by two hands; If Ban-manipulation is operated with traction, new injury could be avoided for intervertebral space is broadened, joints are relaxed and muscle spasm is relieved; When the patient sits upright, rotation space of the hand is more, which is convenient for operation, but if the patient lies on his back, it's more safe.Conclusion:As ban-manipulation is difficult to operate, there may be an accident if misoperation. For security, doctors should pay attention to the following:1. Combining Inquiry of the medical history in detail,physical examination,X-ray result, symptoms and the pathophysiologic statement of patient ,make the correct diagnose.2. If the patient sits upright, the doctor should stand behind the abnormal side; While the patient lies on his back, doctor should stand or sit on the head side or abnormal side.3. Avoid violence by all means, ban-manipulation should be carried out after patient's attention distracted, patient's head rotated or turned to one side to the maximum extent, which could achieve best treatment effect using weakest force.4. Clicking sounds isn't the only standard to whether the manipulation is successful, feeling of sliding or adrift motion also means the manipulation is successful. So in order to judge the result easily, location is suggested before ban-manipulation is operated. Also the following must be referred to: Patient's feeling, improvement of symptoms, muscle statement of the two sides of abnormal cervical vertebra and X-ray result.5. Extent of ban-manipulation: In Side ban-manipulation, the patient's head should be pushed quickly to a further small amplitude about 3°～5°; In Rotational ban-manipulation, it's better to take advantage of rotation inertia to carry out the manipulation with a small Rotational extent; If the patient lies on his stomach, the deviated spinous process of the cervical vertebrae should be pressed against by root of one palm, while shoulder be pressed by the other hand, opposite force by the hands should stop immediately when feeling of sliding motion occur.6. Contraindications of the : The one who has motion organ disease for example osteoporosis and deformity of spinal column, or diseases which are not suitable for ban-manipulation, such as High blood pressure,Arteriosclerosis,diseases on vertebral artery,severe heart or liver diseases and so on.