| Objective:Cervical Spondylopathy of Vertebral Artery (CSA) is among the osteopathic common diseases, which is a series of clinical syndrome characterized as vertebral basilar artery blood insufficiency caused by the internal and external cervical vertebrae disequilibrium due to cervical degeneration. And vertigo, dizziness, headache, neck-shoulder pain, tinnitus, insomnia, disorders of vision, memory and balance are its common manifestations. CSA is a common and frequently-occurring disease, which makes approximately 10%-15% of the cervical spondylosis. The complex symptoms, as dizziness, headache, tinnitus and blur vision, are mainly caused by insufficient vertebral artery blood supply to cerebellum and labyrinthine. Manipulation, among which the rotation manipulation is the most frequently used, has been proved effective in clinical treatment for CSA. Symptoms can b'e alleviated or eliminated by limited rotation manipulation with its reducing oppression on vertebra artery by spur. Whereas excessive rotation should be avoided to protect vertebral artery from being stretched and aggravate the blood insufficiency, and especially, chiropractic manipulation of rotational reduction on cervical vertebral should be applied prudently or considered non-application for patients with vertebral arteries variation and apparent arteriosclerosis. Currently, medical accidents in clinical manipulation are not clearly aware due to insufficient research, in which more studies focuses on summary of clinical experience, on cervical rotation manipulation. In this study, we determined the predilection segments in cervical spondylopathy through collecting data of cervical vertebra in antiseptic cadavers. Models of simulated normal adult cervical vertebral orthostatism and 10°and 30°front curvature were created and conducted left and right rotation within certain range. The data of safe rotation angle under above cervical vertebral postures were attained by detecting drop rate in vertebral artery separately.Methods:Data were collected from cervical vertebra in 10 antiseptic adult cadavers with vernier caliper. Then the intact vertebrae specimen were taken from 6 randomly selected cadavers, 3 males and 3 females. Models of simulated normal adult cervical vertebral orthostatism and 10°and 30°front curvature were created using appropriate fresh brachial arteries as simulated cervical vertebral arteries, and 0.9% normal saline was perfused with 120 mmHg pressure and a constant injection rate, then the vertebrae were limitedly rotated and the drop rate was evaluated.Results:1 Maximum space between the bilateral vertebral arteries appeared in C1, and second in C2, while minimum is C5. Shortest distance between vertebral arteries and intervertebral discs was located at C5～C6. Lowest height of transverse foramen was in C2 and C3; of C5 and C6, the obviously less transverse diameter and higher transverse foramen heigbt than the rest cervical vertebrae were detected; and longest distance between vertebral arteries was observed at C1～C2.2 Through studying the flow variation by rotating cervical vertebrae in simulated models in orthostatism and 10°and 30°front curvature, we observed decreases in bilateral vertebral arteries in rotation with orthostatism with 0°～45°, but obvious reduce was seen in 30°～45°in opposite side of rotation, which was inconsistent with that of rotary side. Rotation in 10°front curvature indicated reduce in drop rate in opposite site, whereas obvious decrease can be seen in 15°～30°in opposite rotary side when compared with that of rotary side. Both the drop rate was the same in rotation with 30°for the Rotation in 10°front curvature. For models of 30°front curvature, the artery of opposite rotary side was stretched obviously whail rotationrange from 15°to 30°, while was not obviously.when rotation range from 0°to 15°and 30°and 45°Conclusions:1 CSA is frequently occurred at C1, C2 and C5.2 0°～45°is a safe rotation range of orthostatism and models of i0~ front curvature, and the artery of opposite rotary side was stretched obviously in 30°～45°for the orthostatism.3 For models of I0~ front curvature, both the artery was the same degree stretched, while the artery of opposite rotary side was stretched obviously in 30°～45°4 For models of 30°front curvature, rotation range from 0°to 30°is of few risk, while the artery of opposite rotary side was stretched obviously whail rotation range from 15°to 30°... |
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