Assessing The Efficacy Of Muscle Relaxation Combined With Orthopedic Manipulation On Neck Type Cervical Spondylosis By Musculoskeletal Ultrasound Technology

[Objective]To examine the efficacy of muscle relaxation combined with orthopedic manipulation on neck type cervical spondylosis（NTCS）by the musculoskeletal ultrasound technology to provide objective evidence for its clinical application.[Methods]Sixty-six patients with NTCS who met the inclusion criteria were randomly divided into muscle relaxation combined with orthopedic manipulation group and normal acupuncture group,each group consisting of 33 patients.Two groups were treated once every other day for a total of 3 times.The thickness and Young’s modulus（E value）of splenius capitis and semispinalis capitis as well as the VAS and NDI scores were recorded before and after treatment in both groups to evaluate the clinical efficacy.Correlation analysis of E value of cervical extensors with VAS and NDI scores was performed.Evaluating the efficiency of the VAS,the NDI,the E value of splenius capitis and semispinalis capitis in assessing clinical effects through receiver operating characteristics（ROC）.[Results]1.Clinical symptom scores:VAS and NDI scores decreased in both groups after treatment compared with those before treatment,and the differences within and between groups were statistically significant（P<0.05）.2.The thickness of cervical extensors:After treatment,the thickness of splenius capitis and semispinalis capitis increased slightly in both groups compared with that before treatment,but the differences were not statistically significant in either intra-group or inter-group comparisons（P>0.05）.3.E value of cervical extensors:After treatment,the E value of splenius capitis and semispinalis capitis decreased in both groups compared with those before treatment,and the differences were statistically significant within and between groups（P<0.05）.4.Clinical effectiveness:The total effective rate of the treatment group was 93.8%,and the control group was 86.2%,comparing the clinical efficacy of the two groups,the difference was statistically significant（P<0.05）.5.Correlation analysis showed a positive correlation between the E value of the splenius capitis and the VAS scores（r=0.650,P<0.001）as well as the NDI scores（r=0.450,P<0.001）,and a positive correlation between the E value of semispinalis capitis and the VAS scores（r=0.732,P<0.001）as well as the NDI scores（r=0.623,P<0.001）in two groups.6.The ROC results showed that the area under the curve（AUC）of VAS or NDI combined with E value of cervical extensors for assessing clinical efficacy was significantly higher than the AUC of the individual items alone.[Conclusion]1.Muscle relaxation combined with orthopedic manipulation can effectively reduce the muscle stiffness of the cervical extensors,alleviate pain symptoms,and improve the mobility of the cervical spine in NTCS patients.The overall efficacy is better than that of conventional acupuncture in a relatively short course of treatment.2.The E value of splenius capitis and semispinalis capitis in NTCS patients collected by musculoskeletal ultrasound technology provided some basis for reflecting the changes in soft tissue elasticity of cervical extensors before and after treatment.