Objective To observe and measure the approach next to the erector spinae in the thoracic and lumbar segments of the spine and adjacent anatomical structures by the topographic method, to clarify the positioning method and safe range so as to provide the anatomical basis of the approach for spinal canal decompression. Methods Twelve formaldehyde-treated adult cadaver specimens were selected, including 6 males and 6 females with an average age of 43 years (range, 27-52 years) and with an average height of 166 cm (range, 154-177 cm). The related data of the approach at T1-S1 levels were respectively measured: the distance between the lateral edge of the erector spinae and the spinous process, the length of the approach, the angle between the approach and the horizontal plane, the size of intervertebral foramen, and the vertical distance between the segmental artery and the upper edge of the vertebrae. Results The distance between the lateral edge of the erector spinae and the spinous process ranged from (41.75 ± 3.29) mm to (74.54 ± 7.08) mm. The length of the approach ranged from (66.75 ± 10.81) mm to (97.13 ± 13.35) mm. The angle between the approach and the horizontal plane ranged from (38.38 ± 6.16)° to (53.67 ± 4.40)°. The vertical distance between the segmental artery and the upper edge of the vertebrae ranged from (9.50 ± 0.60) mm to (18.30 ± 1.56) mm. The size of foraminal was also measured. The spinal canal could reach when iliocostalis lateral edge was used as the starting point in the lumbar segments, and longissimus lateral edge as the starting point in the thoracic segments. It was confirmed that there was enough safe space for the spinal decompression without the resection of the articular process. Conclusion The approach next to the erector spinae can reach spinal canal to achieve the purpose of decompression through the intervertebral foramen. The minimally invasive approach is feasible and safe. It has the value of the operative application.
Objectives To systematically review the efficacy and safety of bonesetting combined acupuncture in the treatment of cervical vertigo. Methods PubMed, CNKI, VIP, CBM and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on bonesetting combined acupuncture in the treatment of cervical vertigo from inception to February 15th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.3 software. Results Eighteenth RCTs involving 1 915 patients were included. The results of meta-analysis showed that, compared with acupuncture or bonesetting alone group, the effective rate in bonesetting combining acupuncture group was higher (RRacupuncture=1.17, 95%CI 1.12 to 1.23, P<0.000 01; RRbonesetting=1.16, 95%CI 1.10 to 1.23, P<0.000 01). Improvement of the cervical vertigo symptom and function in the combined group was better than that in the acupuncture group or bonesetting group (MDacupuncture=3.42, 95%CI 2.29 to 4.56, P<0.000 01; MDbonesetting=6.45, 95%CI 5.56 to 7.33, P<0.000 01). Average flow velocity of cervical vertigo basilar artery (BA) in the combined group was superior to the bonesetting group (MD=7.54, 95%CIP=0.02). 1.08 to 13.99, Conclusions Bonesetting combining acupuncture treatment of cervical vertigo in terms of effectiveness and function improvement are better than those of acupuncture alone or pure bonesetting. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
ObjectiveTo overview the reporting and methodology quality of systematic reviews/meta-analysis on acupuncture in the treatment of primary osteoporosis (POP).MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect systematic reviews/meta-analysis on acupuncture in the treatment of POP from inception to July 2018. Two reviewers independently screened literature, extracted data, and assessed the quality of systematic reviews. A Measurement Tool to Assess Systematic Reviews (AMSTAR) methodological quality score and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used to assess the methodological quality and reporting quality of the systematic reviews, along with the risk of homogeneity and publication bias.ResultsA total of 11 systematic reviews/meta-analysis were included and multiple evaluations of the radar plot showed that the quality average rank scored 7.68. The major problems in studies were lack of items registration, imperfect search strategies and selection bias and so on.ConclusionThe quality of systematic reviews/meta-analysis of acupuncture in the treatment of POP is insufficient, indicating that the methodological and reporting quality of systematic reviews should be further strengthened.