Association Study About Clinical Application Of Needle-knife And Suboccipital Muscles Anatomy And Treatment Of CSA

Backgroud:Cervical spondylotic vertebral arteriopathy (CSA), mainly with the symptom of episodic vertigo, accompany with headache, tinnitus, pain in eyes, blurred vision and even faint. The pathogenesis is complicated. It is widely believed that the theories of me chanical compression and sympathetic nerve stimulation Are involved with the pathogenesis. In traditional view, CSA is caused by the degenerative changes of structure such as ver tebrae and intervertebral disc. And vertebrobasilar insufficiency (VBI) is the main reason.. It is treated mostly in the view of primary diseases as cervical disc herniation. Howeve r, although the primary disease is cured, symptoms of CSA still exist and even become worse. Gradually, researchers realized that cervical muscle was greatly related with the o ccurrence of CSA, especially the disorder of suboccipital group which is related with ver tebral artery. According to the theory of myofascial pain, disorder of skeletal muscles ca n easily cause myofascial pain of trigger points. Clinically, it is common to treat myofas cial pain of suboccipital muscles and pain of head and neck and CSA radiating to suboc cipital muscles with needle-knife. But there are few reports on the study of myofascial p ain of suboccipital muscles, which mostly be considered as headache, atlanto-axial sublux ation, contracture of atlanto-occipitalis posterior etc. Besides, although symptoms of myof ascial pain of suboccipital muscles is similar to those of CSA based on literature review, there is no relevant reports on the relationship between CSA and myofascial pain. Ther efore, the author studied on curative effect mechanism of nature of the needle-knife thera py method on suboccipital muscles myofascial pain syndrome and the relationship betw een CSA and myofascial pain of suboccipital muscles to discuss new way to treat CSA.Objective:1. To investigate the suboccipital muscles myofascial pain syndrome From the perspective o f TCM, To verify the effectiveness of the needle knife in the treatment of myofascial pai n by the reinforcement theory of TCM in clinical application, and to clarify Accupoto mology suboccipital muscles myofascial pain syndrome essence.2. to study the needle knife therapy path of Suboccipital muscles myofascial pain syndro me by observing anatomical experiments suboccipital muscles and vertebral artery tiss ue anatomy, release the suboccipital muscles for clinical needle knife therapy CSA bo dy positioning.3. to verify the research result of applied anatomy by Suboccipital muscle MPS needle knife therapy.to explain effects and characters of needle-knife on myofascial pain of suboccipital muscles.and to explore the influence of suboccipital muscle MPS and C SAMethod:1. literature theory research Refered to the hand, foot-taiyang in "Neijing", and the description of Myofascial pain syndrome of suboccipital muscles on The "Travell and Simons’"The Myofascial pain and dysfunction of The trigger point manual " and Suboccipital muscles applied anatomy related literature to explore the relationship between the overall control. From Suboccipital muscles and physiological anatomy of vertebral artery, the pathogenesis of CSA, and to comparative analysis of clinical literature reported suboccipital muscles myofascial pain syndrome and the relevance of CSA.2. Anatomy experiment research Randomly selected specimens of adult body anatomy teaching each a men and women, and used of anatomical tools according to the conventional profile control, step by step a dissection method from outside to inside, in turn to observe cervical occipital muscles level characteristics, suboccipital muscles what structure and anatomical distribution characteristics.adjacent to it.4. clinical research of The needle knife According to the patients who come from Nanjing combine traditional Chinese and western medicine Hospital with voluntary basis,60 cases of CSA patients, were randomly divided into two groups,30 cases in each group. The treatment group was applied with needle knife release suboccipital muscles MTrp therapy, the control group with traditional acupuncture treatment.The two groups are two courses of treatment.statistical analysis of the results after 6 months follow-up.Result:1. Theory of literature research:Comparative study of suboccipital muscles myofascial pain syndrome with the hand, foot-taiyang reinforced the description of the disease closely matched, show myofascial pain syndrome is a modern language description of muscle disease.Application of the reinforcement theory of traditional Chinese medicine combined with modern medical theory research needle knife curative effect, for the needle knife therapy suboccipital muscles myofascial pain syndrome clinical methods and mechanism of nature research laid the foundation. Comparative study suboccipital muscles MPS and CSA, found myopathic changes under the pillow can cause vertebral artery atlanto-axial period of function change, clinical symptoms of CSA.2. Anatomy experiment:Suboccipital muscles is close to the vertebral artery Vertebral artery measured specimen of atlanto-axial diameter respectively male:atlanto-axial:left 3.78 mm,3.68 mm to the right,Atlas pillow:left 4.14 mm, right 3.82;Female:atlanto-axial:left 3.46 mm,2.98 mm to the right,Atlas pillow segment:left,3.623.26 mm to the right.Atlas transverse process pointed away from the spacing of mastoid tip:man:left 19.24 mm,20.06 mm to the right,Female: left 16.87 mm. The right 16.87 mm;Vertebral artery horizontal extension from the axis of vertical spacing on:man:left 16.72 mm,17.06 mm to the right,Female:left 15.64 mm,15.71 mm to the right,Vertebral artery horizontal spacing between the outer rim from mastoid:man: left 18.81 mm,18.47 mm to the right,Female:17.09 mm,16.52 mm to the right,3. Clinical research:Verified by palpating and combining the patients complained of suboccipital muscles MPS clinical symptoms and scope of referred pain, is found Similar clinical manifestations and pain;Clinical comparative observation, needle knife treatment group total effectiveness 93.3%, control group was 66.7%, which compare the difference was statistically significant (P< 0.05), compared two groups by chi-square test, difference was statistically significant (chi-square= 9.5, P< 0.01). In the two groups before and after treatment group comparison, pain VAS score, vertigo symptom scores differences statistically significant (P< 0.05);Comparison between the two groups after treatment group, pain VAS score, vertigo symptom scores differences statistically significant, needle knife therapy group is better than that of control group (P<0.05).Conclusion:1. Suboccipital muscles MPS after reinforcement and its symptoms was consistent wi th the Taiyang Channel, suggests that the muscle lesions is TCM pathogenesis of MPS.c ombining with the characteristics of clinical treatment of needle knife and confirmed the needle knife in the treatment of MPS mechanism properties of traditional Chinese medici ne in clinical application. Vertebral artery atlanto-axial period of soft tissue lesions caused by CSA and suboccipital muscles MPS have contact.2. The diameter of the pathway of vertebral artery in suboccipital segment increase gradually, curved surfaces, and suboccipital muscles and surrounding surface osseous mar ks adjacent location, select the muscle belly into clinical needle knife therapy should not be commonly, security into the needle point generally choose apophysis in muscle attac hment points, should be paid attention to when the needles are inserted depth, careful op eration.Transverse process in atlas, needle blade to fixed on the bone surface apophysis, no needle cut, swaying slightly to do, should not be mobile needle sharp edge, so as to avoid injury of vertebral artery.3. Small needle knife through suboccipital muscles loose solution treatment suboccipi tal muscles MPS, curative effect is remarkable.At the same time can effectively treat vert ebral artery atlanto-axial period of soft tissue factors of CSA, obviously improve the sym ptom such as dizziness and headache.Therefore, The author thinks reasoning vertebral art ery atlanto-axial segment by conformity or stimulation mechanism caused by CSA clinica 1 symptoms are caused by cervical vertebra degeneration of secondary MPS, the vertebral artery atlanto-axial caused by the conformity of or stimulate the CSA and suboccipital muscles MPS is relevant.