Influence of different end-range upper cervical rotation on the vertebral artery lumen
ZHANG Fa-yao, FENG Min-shan, ZHU Li-guo
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (1) : 71-76.
Influence of different end-range upper cervical rotation on the vertebral artery lumen
Objective To analyze the influence of different end-range cervical rotation on the vertebral artery lumen with CTA. Methods To trim 8 fresh cervical adult specimens with upper cervical spine(C0~4) is used to build the vitro model loaded 3 kg of vertebral artery. Contrast agent is injected into vertebral artery and the vertebral artery cross-sectional area in the section(C1,C1/2, upper part of C2 vertebral body 1/3, lower part of C2 vertebral body,C3) of the cervical spine were measured by CT in the end-range cervical positions fixed by gimbal mounting: The data were analyzed to study the mechanism of action of vertebral artery space form out of neurohumoral regulation control. Results The end-range rotation and the end-range extension rotation caused homolateral vertebral artery stenosis (P<0.05), not on heterolateral (P>0.05), and narrow areas always appeared on upper part of C2 vertebral body 1/3. Conclusion (1)The composite vitro vertebral artery model loaded can be used to analyze the influence of different end-range cervical rotation on the vertebral artery lumen with CTA; (2) The end-range rotation and the end-range extension rotation caused homolateral vertebral artery stenosis out of neurohumoral regulation control, and narrow areas always appeared on upper part of C2 vertebral body 1/3 （The outside of the atlantoaxial lateral mass）.
Upper cervical / End-range rotation / Vertebral artery / Lumen / Computed tomography angiography
[1] Thomas LC, Mcleod LR, Osmotherly PG, et al. The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow: A sub analysis of an MRI study[J]. Man Ther, 2014, 20(3): 475-480.
[2] Cattrysse E, Gianola S, Provyn S, et al. Intended and non-intended kinematic effects of atlanto-axial rotational high- velocity, low-amplitude techniques[J]. Clin Biomech, 2015, 30(2):149-152.
[3] Quesnele JJ, Triano JJ, Noseworthy MD, et al. Changes in vertebral artery blood flow following various head positions and cervical spine manipulation[J]. J Manipulative Physiol Ther, 2014, 37(1): 22-31.
[4] Bowler N, Shamley D, Davies R. The effect of a simulated manipulation position on internal carotid and vertebral artery blood flow in healthy individuals[J]. Man Ther, 2011, 16(1):87-93.
[5] Mitchell J, Kramschuster K. Atypical suboccipital vertebral artery blood flow in healthy subjects: case studies using real-time ultrasound[J]. Ecs Transactions, 2009, 57(1):228-240.
[6] Mitchell J. Vertebral artery blood flow velocity changes associated with cervical spine rotation: a meta-analysis of the evidence with implications for professional practice[J]. J Man Manip Ther, 2009, 17(1):46-57.
[7] Budgell B, Sato A. The cervical subluxation and regional cerebral blood flow[J]. J Manipulative Physiol Ther, 1997, 20(2):103-107.
[8] Hong JT, Lee SW, Son BC, et al. Analysis of anatomical variations of bone and vascular structures around the posterior atlantal arch using three-dimensional computed tomography angiography[J]. Neurosurg Spine, 2008, 8(3): 230-236.
[9] 付小勇. 寰枢椎骨性测量及寰枢关节运动学研究[D]. 广州:南方医科大学博士学位论文, 2010: 52-58.
[10] 李义凯, 张云昆, 钟世镇. 颈部旋转手法对椎动脉流速影响的研究[J].中国中医骨伤科杂志, 1997, 5(5):7-9.
[11] 魏佳军, 章军建, 肖劲松．颈性眩晕患者血浆内皮素和降钙素基因相关肽测定的临床意义[J]. 卒中与神经疾病, 2005, 12(1):38-39.
[12] 马江涛, 张银刚, 袁启令, 等.颈性眩晕的发病机制、诊断和治疗研究进展[J]. 中医正骨, 2016, 10(28):32-37.
[13] Skutta B, Furst G, Eilers J, et al. Intracranial stenooclusive disease; double-detector helical CT angiography versus digital subtraction angiography[J]. Am J Neuroradiol, 1999, 20(5):791-799.
[14] 戚跃勇, 邹利光, 任先军, 等. 人体椎动脉标本的 DSA、MSCTA及MRA测量对照研究[J]. 颈腰痛杂志, 2008, 29(1):13-16.
[15] 辉昊, 陈博, 詹红生, 等. 流固耦合分析颈椎生理活动对椎动脉血流动力学的影响[J]. 医用生物力学, 2014,29(12):511-516.
[16] 刘奎. 有限旋转手法对椎动脉型颈椎病的相关骨性解剖学结构的研究[D]. 湖北：湖北中医学院, 2007:12-13.
[17] 张奎启, 王福, 卢云, 等. 椎动脉第2、3段的应用解剖[J]. 解剖学杂志, 2004, 27(5):563-564.
[18] Wuest S, Symons B, Leonard T, et al. Preliminary report: biomechanics of vertebral artery segments C1-C6 during cervical spinal manipulation[J]. J Manipulative Physiol Ther, 2010, 33(4):273-278.
[19] 洪水棕, 吴振坤, 祝曙鸣. 人体颈椎的力学实验研究[J]. 中国医学生物工程学报, 1987, 2(6):75-83.
[20] 吕绍茂, 段少银, 林清池, 等. 三维CT研究头颈部旋转后寰枢关节与椎动脉的关系[J]. 中国医学影像学杂志, 2014, 22(8):561-564.
[21] Felbaum DR, Ryan JE, Stemer AB，et al. Bilateral subaxial rotational vertebral artery occlusion in a setting of a prior cervical construct[J] . World Neurosurg, 2017, 97(1): 5-10.
[22]Salem W, Lenders C, Mathieu J, et al. In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation[J]. Man Ther, 2013, 18(4):339-344.
[23] Penning L , Wilmink JT . Rotation of the cervical spine. A CT study in normal subjects [J]. Spine, 1987, 12( 8):732-738.
[24] 朱岩, 向卫国, 梁文杰, 等. 螺旋 CT 三维重建对上颈椎损伤的诊断价值[J]. 中国矫形外科杂志, 2007, 15(4):254-256, 324.
[25] 赵雄, 雷伟, 吴子祥, 等. 上颈椎椎间旋转活动在体三维测量与分析[J]. 中华实用诊断与治疗杂志, 2009, 23(7): 653-655.
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