Clinical Significance Of Tenderness Of Pouch Behind Matoid In The Diagnosis Of Vertebral Artery Type Of Cervical Spondyosis

Objective:To explore the clinical significance of tenderness of pouch behind matoid in the diagnosis of vertebral artery type of cervical spondylosis.Methods: ①Application the level anatomical to dissect the 10 adult cadaver,Exposure and free the vertebral artery between the axial transverse foramen and posterior atlantooccipital membrane.To observe the shape and morphology of vertebral artery.Measurement the outside diameter of vertebral artery in different parts and the distance between arch of posterior atlas and vertebral artery in groove.Measurement the angel of the vertebral artery through the transverse foramen.Take pictures of important structure.②Collected 50 patients from January 2015 to January 2016 of clinic and sickroom who consistent with the diagnostic code of CSA.Pressed the pitting behind the mostoid and record the pain of all cases.Then,the magnetic resonance imaging were carried out for every patient.Two attending doctors of orthopedics to check the MRI and record the consequence.Compared the data from the above two methods.Application of SPSS19.0 software to statistical analysis the data of experimental study and clinical observation.Result:There were course exception and absent of vertebral artery between the axial transverse foramen and posterior atlantooccipital membrane in 10 adult cadaver.Multiple obviously curvatures in speciments and compensatory vascular expansion in curvatures was found.Vertebral artery had different distance compared with the arch of posterior atlas.right and acute angel was observed in transverse foramen of atlas.We found 76 sides tenderness in 50 patients(100 sides).After examination of magnetic resonance imaging(MRI)about all invalid,73 cases was pressed by bone or soft tissues around the vertebral artery among 100 cases.We got the final result analyzed by SPSS19.0.The correlation coefficient:r=0.565.P< 0.05.They were moderate related between the results.The evaluation analysis of diagnostic test:correct rate is 89%;index of YI is 0.686.Conclusion:(1)Vertebral artery in groove has obvious protrude relative to the arch of posterior atlas.Easy to receive the outside stimulation and show the corresponding symptom.(2)On the anatomy,vertebral artery is close to the former branch of C1 nerve and the root of C2 nerve.Otherwise,the great occipital nerve distribution in the pouch of behind matoid.These nerves can be stimulated by lesions vertebral artery.(3)The FengChi Piont is include in pitting behind of matiod.(1)Through the tenderness of pouch of behind matoid found the CSA patients was positive correlation with the result of magnetic resonance imaging.The tenderness of pouch of behind matoid has high clinical value.(2)The vertebral artery pressure parts always take place in the cervical vertebrae C1,C2,C5 which have wide activity.The lesion cervical vertebrae can stimulus the great occipital nerve,lesser occipital nerve and suboccipital nerve,and creation the corresponding symptom.