The Study About The Effect Before And After Traction In Cervical Spondylosis Of Vertebral Artery Type By Color Doppler

Objective: On the basis of the position about anatomic form of arteria vertebralis and different diseased region ,the study divides patients suffering from vertebral artery type of cervical spondylosis (CSA) into groups. Judging therapeutic effect of traction through color Doppler (CDFI) and transcranial Doppler (TCD) adding the test of turning neck , analyze the change of blood current parameter before and after the tractions from different direction and angle to offer the best schedule to diagnose and cure CSA in clinical.Method: On the basis of diseased region ,we divide cervical syndrome into 3 types .They are superior part(C1～C3), inferior part(C4～C6) and commixture. On the basis of traction modus, we divide cervical syndrome into the anteversion sitting position group: 1～10°, 11～20°and 21～30°;meta stretch sitting position group: 1～10°, 11～20°and 21～30°; neutral position sitting position group .There are 7 groups in together and there are 5 patients in per type of per group .In control group(region cheirapsis group),there are 15 patients for comparison .There is no special restriction about the patients'age and sex .We take suction in ran on the basis of diseased region .In general ,the traction weight is 6—9kg.The patient takes traction once per day ,and every traction lasts 30min.In every course of treatment ,there are 10 tractions .Every group takes 1—3 course of treatment .Taking detection of CDFI and TCD before and after therapy ,observing and comparing the change of blood current parameter before and after therapy ,analyzing and adding up the data, we judge therapeutic effect.Result:1.In the treatment about 120 cases of cervical syndrome ,the cure rate is 0 and the therapeutic effective power is 40% in control group(region cheirapsis group) .However, the cure rate is 18.1% and the therapeutic effective power is 73.3% in traction therapy group .The therapeutic efficacy of traction therapy is better than that of region cheirapsis therapy .2.In the 35 patients suffering from affection in upper hind neck ,the therapeutic efficacy in meta stretch sitting position occupying 11～20°is best ,and its cure rate is 60% and its therapeutic effective power is 100% .We take left vertebral artery as an example : the blood flow rate peak value of period of contraction (Vp) before therapy (before meta neck) is 68.16±7.39cm/s ;the average blood flow rate (Vm) is 53.56±4.76cm/s;the Vp after therapy (before meta neck) is 55.16±5.49cm/s ; the Vm is 38.76±4.89cm/s. The blood current parameter before and after therapy is obvious different (p<0.05) .3. In the 35 patients suffering from affection in inferior neck , the therapeutic efficacy in anteversion sitting position occupying 11～20°is better. We take left vertebral artery as an example : through CDFI we know that the blood vessel inner diameter (D) is 2.7±0.22mm before therapy (before meta neck) and D after therapy (before meta neck) is 3.6±0.44mm; through TCD we know that Vp is 38.16±9.02cm/s,Vm is 22.06±6.22cm/s before therapy (before meta neck) and Vp is50.18±4.15cm/s,Vm is 31.46±2.97cm/s after therapy (before meta neck) . The blood current parameter before and after therapy is obvious different (p<0.05) .4. In the patients suffering from affection in neutral position sitting position, the therapeutic efficacy in anteversion sitting position occupying 1～10°is better. We take left vertebral artery as an example : through CDFI we know that the blood vessel inner diameter (D) is 2.82±0.47mm before therapy (before meta neck) and D is3.4±0.26mm after therapy (before meta neck) ; through TCD we know that Vp is36.18±8.20cm/s,Vm is 21.68±4.12cm/s before therapy (before meta neck) and Vp is 53.48±6.58cm/s,Vm is33.76±3.08cm/s. The blood current parameter before and after therapy is obvious different (p<0.05) . 5.In the CSA in different affection part , the therapeutic efficacy in meta stretch sitting position occupying 21～30°is worst .The average cure rate is 0%, and the therapeutic effective power is 27%. The blood current parameter before and after therapy is not obvious different (p>0.05).Conclusion: First,we type vertebral artery type of cervical spondylosis on the base of anatomic site . On the basis of diseased region ,we divide cervical syndrome into 3 types .They are superior part(C1～C3), inferior part(C4～C6) and commixture. It offers guidance for traction therapy in clinical from spondylous morphous and mechanics .Second, we determine the best angle of traction. On the base of the best angle of traction of vertebral artery type of cervical spondylosis in superior part(C1～C3), inferior part(C4～C6) and commixture ,which is that the therapeutic efficacy in meta stretch sitting position occupying 11～20°is better in upper hind neck; the therapeutic efficacy in anteversion sitting position occupying 11～20°is better in inferior neck; the therapeutic efficacy in anteversion sitting position occupying 1～10°is better in neutral position sitting position .The last , we know that CDFI and TCD are the convenient, integrity,safe and reduplicative methods to guide traction therapy in vertebral artery type of cervical spondylosis.