| Objective: To study the mechanism of using "three-dimensional balance adjustment spine" manipulation to treat patients with cervical spondylotic radiculopathy,analyze the stress changes in the vertebral body and intervertebral disc during the diagnosis and treatment of manipulative techniques.Combined with the clinical curative effect judgement,to provide technical support for further improvement of the guidance technique,at the same time,it provides a safe,effective and standardized therapy system for the treatment of cervical spondylotic radiculopathy by traditional Chinese medicine.Methods: Sixty patients with cervical spondylotic radiculopathy that conform to the diagnostic criteria were randomly divided into two groups.One group was treated with traditional tuina technique;the other group was treated with "three-dimensional balance adjustment spine" technique on the basis of traditional tuina technique.The two groups were treated once every other day and ten times for one course of treatment.After a course of treatment,the symptoms and signs and VAS scores were evaluated before and after treatment in both groups.The effectiveness of the adjust spine manipulation technique is determined by the comparison of clinical efficacy,and the force changes of the manipulation are recorded during the treatment process using a mechanical test system.Afterwards,a neck CT scan image of a healthy male volunteer with typical immediate effect of spine manipulation was collected and the dicom images were acquired;in turn,Mimics medical image processing software,Geomagic Studio reverse engineering software,ANSYS Workbench finite element analysis software,and the two-way transfer function with CAD software parameters was used to establish a three-dimensional finite element model of cervical spondylotic radiculopathy.Furthermore,it was decomposed according to the principle of spine manipulation;the seventh cervical vertebra was simulated and fixed,and loaded force on the fifth cervical vertebra.The mechanical parameters of each part were substituted into the finite element model,used ANSYS software for three-dimensional finite element analysis,and observed the intrinsic stress and deformation of the vertebral body,posterior structure,and intervertebral discs of a patient with a cervical spondylotic radiculopathy treated by the "three-dimensional balanced adjustment spine" manipulation technique.Results: 1.After the course of treatment,the total effective rates of the adjustment spine treatment group and the tuina control group were 90.00% and 63.33% respectively,the cure rates were 33.33% and 6.67% respectively.The VAS scores and Tianzhong Jingji scales after treatment in both groups were significantly improved(P < 0.01),but the adjustment spine treatment group improved more significantly than the tuina control group(P<0.01);It is indicated that the three-dimensional balanced adjustment spine manipulation has a significant effect in clinical treatment,and can significantly relieve the symptoms of patients.2.A finite element model of C3~C7 patients with cervical spondylotic myelopathy was established,including 5 vertebral bodies,4 intervertebral discs and 6 ligaments,involving 146,017 nodes and 65775 units.3.After the manipulation was completely loaded on the model,the stress concentration of the vertebral body in C3~C7 was mainly in C3 and C4 spinous process,C5 spinous process anterior part and root part,the vertebral arch,and the junction of the them.The deformed parts were mainly focused on the C3 vertebral body articular process and the front of transverse process,the C4 vertebral body superior articular process and transverse process,C5 vertebral body articular process.C3~C7 intervertebral disc stress was mainly distributed in the nucleus pulposus of the C4/5 and C5/6,and the anterior with the intervertebral disc of C3/4.The deformation and displacement were extended to the posterior portion of the C3/4 nucleus pulposus,C4/5 and C5/6 nucleus pulposus and the anterior intervertebral disc.Conclusion: This study not only from the clinical point of view to prove the therapeutic effect of the "three-dimensional balanced adjustment spine" manipulation,but also established the three-dimensional finite element model of C3~C7 cervical spondylotic radiculopathy patients with more accurately simulates the geometry and material properties of cervical vertebra,and it can more accurately reflect the biomechanical characteristics of the cervical vertebra.From the aspects of basic research,it is also indicated that the "three-dimensional balanced adjustment spine" manipulation will not damage the normal cervical vertebra structures,and the deformation of the intervertebral disc,which provide support for the improvement the pain mechanism of the adjustment spine manipulation. |
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