[Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers].

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers / 中华劳动卫生职业病杂志

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Cervical balance and clinical outcomes in cervical spondylotic myelopathy treated by three-level anterior cervical discectomy and fusion and hybrid cervical surgery: A CONSORT-compliant study with minimum follow-up period of 5 years.

ABSTRACT: As the technology of combining with fusion and nonfusion procedure, cervical hybrid surgery (HS) is an efficacious alternative for treatment with cervical spondylotic myelopathy. While studies on cervical alignment between 3-level HS and anterior cervical discectomy and fusion (ACDF) were seldom reported. The effects of cervical imbalance on its related clinical outcomes are yet undetermined as well.Patients with cervical spondylotic myelopathy, who underwent 3-level ACDF or HS, were included to compare cervical alignment parameters after surgery and then explore the relationship between cervical balance and clinical outcomes.Forty-one patients with HS (HS group) and 32 patients who with ACDF (ACDF group) were reviewed from February 2007 to September 2013 with the mean follow-up of 90.3 ±â€Š25.5 (m) and 86.3 ±â€Š28.9 (m), respectively. Cervical alignments parameters including the C2 to C7 cervical lordosis (CL), C2 to C7 sagittal vertical axis, T1 slope. and T1SCL (T1 slope minus CL), and the clinical outcomes like neck disability index (NDI) and Japanese Orthopedic Association (JOA) score were measured and recorded preoperatively (PreOP), intraoperatively, and on the first preoperative day and the last follow-up (FFU). The balance and imbalance groupings were sorted based on the T1SCL: T1SCL≤20°,balance; T1SCL > 20°, imbalance.We found significant improvements (P < .001) in NDI and JOA at intraoperatively and FFU after ACDF and HS, and no difference on cervical alignment and clinical outcomes between the 2 procedures on the basis of intergroup comparisons. By between-subgroups comparisons, however, we found significant differences in CL and T1SCL at PreOP (P < .05). Nonetheless, there was no significant difference on the clinical outcomes between balance and imbalance subgroups at FFU at PreOP (P > .05), indicating that the change of T1SCL was not correlated to NDI and JOA at FFU.Both HS and ACDF groups showed significant clinical improvements after surgery. There was no correlation between cervical balance and clinical symptoms.

Clinical Efficacy and Safety of "Three-Dimensional Balanced Manipulation" in the Treatment of Cervical Spondylotic Radiculopathy by Finite Element Analysis.

Cervical spondylotic radiculopathy (CSR) is the most commonly encountered cervical spine disorder. Cervical manipulation has been demonstrated as an effective therapy for patients. However, the mechanisms of manipulations have not been elucidated. A total of 120 cervical spondylotic radiculopathy patients were divided into the "three-dimensional balanced manipulation" treatment group (TBM group) and control group randomly. The control group was treated with traditional massage; the TBM treatment group was treated with "three-dimensional balanced manipulation" based on traditional massage. The symptoms and clinical efficacy of the patients were compared before and after treatment for one month. A three-dimensional finite element model was established. The mechanical parameters were imported to simulate TBM, and finite element analysis was performed. The results showed that the total effective rate was significantly higher in the TBM group compared with the control group. The biomechanical analysis showed the vertebral body stress was mainly distributed in the C3/4 spinous processes; the deformation mainly concentrated in the anterior processes of the C3 vertebral body. The intervertebral disc stress in the C3~C7 segment was mainly distributed in the anterior part of the C3/4 intervertebral disc, and the deformation extends to the posterior part of the C3/4 nucleus pulposus. In summary, these data are suggesting that TBM was effective in CSR treatment. The results of the finite element model and biomechanical analysis provide an important foundation for effectively avoiding iatrogenic injuries and improving the effect of TBM in the treatment of CSR patients.

Acupotomy combined with massage for cervical spondylotic radiculopathy: A protocol for systematic review and meta-analysis.

BACKGROUND: Cervical spondylotic radiculopathy (CSR) is a clinical syndrome of radial neck and shoulder pain. Both Massage and Acupotomy have been widely used in the treatment of CSR, in China and achieved satisfied efficacy. Therefore, the aim of this study is to systematically evaluate the clinical efficacy of acupotomy combined with massage in the treatment of CSR. METHODS: The following electronic databases will be searched: PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Embase, SinoMed, Clinical Trials. gov, the China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. Two review authors independently search databases from their respective inception dates to September 2019 to identify potentially eligible studies. Cochrane Handbook 5.1 risk of bias assessment tool will be used to evaluate the methodological quality of the included studies. The Review Manager 5.3 will be used for all statistical analysis of the final included study. RESULTS: The results of this systematic review and meta-analysis will provide a synthesis of existing evidences for the treatment of acupotomy combined with massage on CSR, especially in improving visual analog scale and symptom score. CONCLUSION: This study will summarize the current evidence of acupotomy combined with massage for the treatment of CSR. This study can further guide the promotion and clinical decisions. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020171825.

Comparison of high-intensity laser therapy and combination of ultrasound treatment and transcutaneous nerve stimulation in patients with cervical spondylosis: a randomized controlled trial.

The aim of the study was to compare the effect of high-intensity laser therapy (HILT) and a combination of ultrasound (US) treatment and transcutaneous nerve stimulation (TENS) on pain, range of motion (ROM), and functional activity in patients with cervical spondylosis (CS). A total of 84 patients with a mean age of 51.54 years (52 women and 32 men) affected by CS were enrolled in this study. Patients were randomly divided into two groups. In group A (42 subjects), patients received 12 sessions of HILT plus exercise, while in group B (42 subjects), they received a combination of US, TENS, and exercise. The outcomes measured were cervical segment ROM, pain level measured by visual analogue scale (VAS), and functional activity measured by neck disability index (NDI) at the end of the therapy. The level of statistical significance was set as p < 0.05. In the two groups, cervical ROM, VAS, and functional scores showed significant changes. Both HILT plus exercise and US/TENS plus exercise effectively increased cervical ROM and reduced pain (with a significant greater decrease in group A). Statistically significant differences in NDI scores were observed after treatment sessions with better results for participants enrolled in group A (HILT plus exercise) Both therapeutic modalities demonstrated analgesic efficacy and improved function in patients affected by cervical spondylosis 4 weeks after the therapy. HILT plus exercise was more effective than US/TENS plus exercise. HILT can be promoted and used in this pathology with positive outcomes. However, further studies are needed to optimize the dose and duration of HILT therapy.

Integrative Korean medicine as a possible conservative treatment for mild cervical spondylotic myelopathy: One-year follow-up case report (CARE-compliant).

RATIONALE: Cervical spondylotic myelopathy (CSM) is the most common spinal cord disorder in older patients. The purpose of this case report is to introduce conservative treatment with integrative Korean medicine (KM) as a possible alternative to surgery in patients with mild CSM. PATIENT CONCERNS: An 81-year-old male with both hand weakness and dysesthesia was diagnosed with CSM and was recommended laminectomy. However, considering the patient's age and the underlying disease, he refused immediate surgery and preferred KM treatment DIAGNOSES:: The diagnosis of mild CSM was based on a modified Japanese Orthopedic Association (mJOA) score as well as the presence of compression on the spinal cord in magnetic resonance imaging findings INTERVENTIONS:: Integrative KM treatment consisting of acupuncture, acupotomy, Bee venom herbal acupuncture, cupping therapy, moxibustion, and herbal medicine was provided during the 12-week admission. OUTCOMES: Clinical improvement was detected with a mJOA score (11 to 17), a numerical rating scale for dysesthesia intensity (5 to 2), finger escape sign (+/+ to +/-), grip and release test (11/14 to 32/31) and grasp power measured by dynamometer (3.1/9.7 to 10.8/18.3 kg) at 12 weeks. This improvement was maintained without surgery until 1 year. LESSONS: This case suggests that integrative KM was a possible conservative management option for mild CSM.

Resting-State Functional Magnetic Resonance Imaging Connectivity of the Brain Is Associated with Altered Sensorimotor Function in Patients with Cervical Spondylosis.

OBJECTIVE: To determine the relationship between functional connectivity (FC) using resting-state functional magnetic resonance imaging (MRI) and neurological impairment in patients with cervical spondylosis and healthy controls. METHODS: A total of 24 patients with cervical spondylosis with or without myelopathy and 17 neurologically intact, healthy volunteer subjects were prospectively enrolled in a cross-sectional study involving observational MRI and evaluation of neurological function using the modified Japanese Orthopedic Association (mJOA) score. Seed-to-seed connectivity and seed-to-voxel connectivity on functional MRI data were performed using a general linear model of connectivity with respect to age and mJOA score. RESULTS: Increased FC was observed with increasing neurological impairment in patients with cervical stenosis within sensorimotor areas, including precentral gyrus, postcentral gyrus, and supplemental motor regions, using both seed-to-seed and seed-to-voxel analyses. The anterior cingulate showed increasing connectivity with the supplemental motor area, thalamus, and cerebellum with increasing neurological function. Similarly, the thalamus, cerebellum, and putamen presented with increasing connectivity to both the bilateral precuneus and the posterior cingulate with an increasing mJOA score. CONCLUSIONS: Patients with cervical spondylosis exhibiting neurological impairment experience changes in brain connectivity similar to that of patients with chronic traumatic spinal cord injury. These results suggest an increase in FC within sensorimotor regions with increasing neurological impairment and decreased connectivity between the cerebellum, putamen, and thalamus to the anterior and posterior cingulate and frontal lobe regions.

Effectiveness of percutaneous neuromuscular electrical stimulation for neck pain relief in patients with cervical spondylosis.

BACKGROUND: This study aimed to evaluate the effectiveness and safety of percutaneous neuromuscular electrical stimulation (PNMES) for treating neck pain in patients with cervical spondylosis (CS). METHODS: One hundred and twenty four patients with neck pain of CS were included, and then they were randomly divided into a PNMES group and a control group in a ratio of 1:1. All patients received PNMES or sham PNMES 30 minutes daily, 3 times weekly for 12 weeks. The primary outcome was assessed by the visual analog scale (VAS). The secondary outcomes were evaluated by the cervical range of motion (ROM), neck disability index (NDI) score, as well as the adverse events (AEs). All outcome measurements were measured at the end of 12-week treatment, and 4-week follow-up after treatment. RESULTS: At the end of the 12-week treatment, and 4-week follow-up, the patients receiving PNMES exhibited more decrease in the mean VAS (P < .01), and NDI (P < .01) respectively, compared with the patients receiving sham PNMES. Additionally, the increase in the mean ROM was also significantly higher in the PNMES group than that in the sham PNMES group at the end of the 12-week treatment, and 4-week follow-up, respectively (P < .01). No AEs were found in either group. CONCLUSIONS: The results of this study demonstrated that PNMES is more effective than Sham PNMES for neck pain relief in patients with CS.

Wet Cupping Therapy Improves Local Blood Perfusion and Analgesic Effects in Patients with Nerve-Root Type Cervical Spondylosis.

OBJECTIVE: To observe wet cupping therapy (WCT) on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis (NT-CS). METHODS: Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture (JA) group according a random number table. WCT group (30 cases) was treated with WCT for 10 min, and JA group (27 cases) was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale (VAS). Blood perfusion at Dazhui (GV 14) and Jianjing (GB 21) acupoints (affected side) was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well. RESULTS: In both groups, the VAS scores significantly decreased after the intervention (P<0.01), while the blood perfusion at the two acupoints significantly increased after intervention (P<0.05); however, the increasement magnitude caused by WCT was obvious compared with JA (P<0.05). CONCLUSIONS: WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.

Effectiveness of acupuncture in the management of cervical spondylosis: a meta-analysis.

Cervical spondylosis is the most common type of spinal pathology which is more common in middle-aged or senile populations with a high potential to affect physical and mental health. This study evaluates the effectiveness of acupuncture in the management of cervical spondylosis. After a detailed literature search in electronic databases, the required data were acquired from selected research articles and meta-analyses were performed to obtain the percent cure, failure and total effectiveness rates under random effects model. Meta-regression was performed to identify the factors affecting the efficacy. Twenty-seven studies were selected for data acquisition (2,853 patients; average age 46.2±9.5; 51.7±12.5% males). Acupuncture alone had 33.41% (25.50, 41.24) cure rate but in combination with other therapies it rose to 53.36% (41.9, 64.8). Similarly, total effectiveness rate was 87.01% (83.40, 90.62) with acupuncture alone and 93.62% (89.85, 97.38) with acupuncture in combination with other therapies. Age was inversely associated with the percent cure rate and the number of combination therapies with acupuncture was positively associated with the cure rate. In conclusion, acupuncture therapy alone can provide cure and total effectiveness rates of 33% and 87%, respectively, but acupuncture with additional therapies can improve the cure and total effectiveness rates to 53% and 94%, respectively. Age inversely affects efficacy and the number of additional therapies improves the efficacy.

[Efficacy of Modified Acupuncture Method at Renying (ST 9) for Patients with Cervical Spondylosis of Vertebral Artery Type and Its Impact on Velocity of Cervical Blood Flow].

OBJECTIVE: To observe the clinical efficacy of modified acupuncture at Renying point (ST 9) for patients with cervical spondylosis of vertebral artery type and its influence on velocity of cervical blood flow. METHODS: Fifty-nine cases of vertebral artery type cervical spondylosis were randomly divided into control group (n=30) and treatment group (n=29). Both groups were acupunctured at ST 9, with routine acupuncture technique used in the control group and modified technique in the treatment group, respectively. All cases received two courses of treatment, each course covered consecutive 6 once-per-day treatments. Before and after treatment, transcranial Doppler (TCD) was used to measure the systolic peak blood flow velocity (Vs) of left vertebral artery (LVA), right vertebral artery (RVA) and basilar artery (BA), and the scores of "cervical vertigo symptoms and functional assessment scale" (CVSFAS) were also assessed, separately. RESULTS: CVSFAS scoring, Vs of LVA, RVA and BA after treatment showed significant improvement compared with those before treatment (P<0.01, P<0.05). The efficacy of the treatment group in the above mentioned indexes was superior to that of the control group (P<0.05). The total effective rate of the treatment group was 93.1% (27/29), superior to 70.0% (21/30) of the control group (P<0.05). CONCLUSIONS: The modified acupuncture method at ST 9 is clinically effective in the treatment of cervical spondylosis of vertebral artery type via increasing the Vs of vertebral-basilar artery, improving the local blood circulation and relieving pain.

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis: a multicenter, single-blind, randomized, controlled, phase â ¢ clinical trial.

OBJECTIVE: To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis. METHODS: This was a multicenter, single-blind, randomized, controlled trial. From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group. The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules. The treatment course was 1 month for both groups. RESULTS: In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group (87.21% ) was significantly higher than that in the control group (80.70%, P < 0.01). After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group (all P < 0.05). In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group (82.07%) was similar to that in the control group (71.21% , P > 0.05). After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group (P < 0.05). CONCLUSION: The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis, and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.

[Acupuncture combined with moxibustion plaster for nerve-root type cervical spondylosis].

OBJECTIVE: To compare the clinical efficacy differences between acupuncture combined with moxi-bustion plaster and electroacupuncture (EA) for nerve-root type cervical spondylosis. METHODS: A total of 60 casesof nerve-root type cervical spondylosis were randomly divided into a plaster group and an EA group, 30 cases ineach one. Patients in the plaster group were treated with regular acupuncture at Jiaji(EX-B 2) points and ashipoints, combined with moxibustion plaster at Gaohuang (BL 43); patients in the EA group were treated with EAat identical acupoints as plaster group. The treatment was given once a day, and 5 days were taken as one course;there was an interval of 2 days between courses and totally 2 courses were performed. The pain questionnaires andquantitative score of signs and symptoms were observed before and after treatment in the two groups. The clinicalefficacy of the two groups was compared. RESULTS: The total effective rate was 96. 7% (29/30) in the plastergroup, which was not significantly different from 93. 3% (28/30) in the EA group (P>0. 05). After treatment,PRI, VAS and PPI were all reduced in the two groups (all P

Pulse changes in patients with cervical spondylosis before and after acupuncture treatment.

OBJECTIVE: To study changes in pulse diagram parameters (PDP) in patients with cervical spondylosis (CS) before and after acupuncture treatment, explore the characteristics of PDP and the relationship between PDP changes and therapeutic effectiveness, and provide evidence for outcome prediction and objective evaluation of CS treatment before and after acupuncture treatment. METHODS: Patients with CS were treated with acupuncture and measured with a pulse acquisition device based on image (PADBI) before the first and after the tenth acupuncture sessions. Changes in PDP from before until after the acupuncture sessions and patient impressions were analyzed to judge the effect of acupuncture treatment for. RESULTS: The PDP values in effective patients were closer to normal values. This indicated that Qi stagnation and blood stasis of the patients was improved. The PDP changes from before to after the first acupuncture treatment were more obvious than those from before to after the tenth acupuncture treatment. This result indicates that the speed of symptom improvement decreased significantly after several acupuncture courses. Analysis of correlation between efficacy and PDP showed that the changes in PDP in five patients was abnormal, which mainly manifested as values of h1, u, p, Pp, and t1, and no significant changes or differences were increased with standard values. This indicated that the symptoms of CS were not improved in these patients. CONCLUSION: PADBI can provide evidence for outcome prediction of acupuncture treatment in patients with CS. PADBI can provide evidence for objective evaluation of acupuncture treatment of CS.

[Effects of Huoxue Dingxuan Capsule Glare on Vertebral Artery Blood Flow,Plasma PAI and t-PA in CSA Rat Models.]

OBJECTIVES: To determine the effects of Huoxue Dingxuan Capsule on vertebral artery blood flow,plasma plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) in rats with cervical spondylosis of vertebral artery type (CSA). METHODS: Ninety healthy male Wistar rats were equally and randomly divided into control,model and treatment groups.The rats in the model and treatment groups were subject to composite modeling manufacturing CSA.The treatment group was given six-week interventions with Huoxue Dingxuan capsule 4 weeks after the modeling.Vertebral artery blood flow,plasma PAI,and t-PA contents were detected before modeling,prior to the interventions,and post interventions. RESULTS: Before the interventions,the rats in the model and treatment groups had significantly lower blood flow of vertebral artery than the controls (P<0.05).The model rats also had increased serum PAI and t-PA contents (P<0.01).After the interventions,significantly higher vertebral blood flow was found in the treatment group compared with the controls (P<0.05).After the interventions,increased serum PAI and t-PA contents were observed in the rats in the model group (P<0.01);whereas,decreased serum PAI and t-PA contents were observed in the rats in the treatment group (P<0.01).The treatment group had lower levels of serum PAI and t-PA contents than the model group (P<0.01). CONCLUSIONS: Huoxue Dingxuan Capsule glare can improve the blood flow of vertebral artery and reduce serum PAI and t-PA contents.

[Efficacy of Acupuncture Combined with Fire Dragon Moxibustion for Patients with Cervical Spondylotic Radiculopathy of Kidney-Deficiency-Cold Type].

OBJECTIVE: To compare the therapeutic effects of acupuncture combined with fire dragon moxibustion and simple acupuncture therapy in the treatment of patients with cervical spondylotic radiculopathy (CSR) of kidney-deficiency-cold type. METHODS: Ninety kidney-deficiency-cold type CSR outpatients were randomly divided into control (acupuncture, n=40) and treatment (acupuncture +moxibustion, n=50) groups. Acupuncture stimulation was applied to Dazhui (GV 14), Ganshu (BL 18), Tianzhu (BL 10) and Houxi (SI 3), Jiaji (EX-B 2), Taixi (KI 3), Shenmai (BL 62), Zusanli (ST 36), Shenshu (BL 23), etc once daily, 5 times a week, and two weeks altogether, except the weekend. In addition, for patients of the treatment group, herbal medicinal powder separated-fire dargon moxibustion was applied to the patient's back from GV14 and Fengmen (BL 12) on the top to Zhibian (BL 54) area at the buttock, once every 3 days, 5 times altogether. The therapeutic effect was evaluated according to "CSR-20-points scale" including 3 aspects as neck-shoulder pain, upper-limb pain-numbness, finger numbness; working and daily life ability and physical conditions (Spurling tests, sensory, myodynamia and tendon reflex). RESULTS: ① After the treatment, CSR-20-points scores in both treatment and control groups were significantly increased in comparison with pre-treatment in each group (P<0.05), with the score being markedly higher in the treatment group than in the control group (P<0.05). ② Of the 40 and 50 cases in the control and the treatment group, 2 and 13 were cured, 14 and 24 experienced a remarkable improvement, 12 and 11 were effective, and 12 and 2 failed, with the total effective rates being 70.0%(28/40) and 96.0%(48/50), respectively. The therapeutic effect of the treatment group was notably better than that of the control group (P<0.05). CONCLUSIONS: Acupuncture combined with fire dragon moxibustion is superior to simple acupuncture therapy in improving clinical symptoms of patients with CSR of kidney-deficiency-cold type, being a recommendable scheme in clinical practice.

[FlU Zhonghua's clinical experience of Fu's subcutaneous needling for cervical spondylosis].

Professor FU Zhonghua's unique clinical experience of Fu's subcutaneous needling (FSN) for cervical spondylosis (CS) is discussed in this paper, which is analyzed from the aspects of recognition of CS pathogenesis, treatment mechanism of FSN, advantage indications of FSN for CS and examples of medical cases. Professor FU introduced the theory of myofascial trigger points (MTrP) into the field of the management of CS. The site of neck MTrP should be carefully examined, and FSN needles for single use are used to sweep the affected area or subcutaneous layer of adjacent upper limb. This method can rapidly improve ischemia and hypoxia state of the relevant muscles and prompt the self-recovery of neck muscles. During FSN treatment, reperfusion approach is recommended to adopt to improve the qi and blood circulation and recovery of neck function.

Characterizing Thalamocortical Disturbances in Cervical Spondylotic Myelopathy: Revealed by Functional Connectivity under Two Slow Frequency Bands.

BACKGROUND AND PURPOSE: Recent advanced MRI studies on cervical spondylotic myelopathy (CSM) revealed alterations of sensorimotor cortex, but the disturbances of large-scale thalamocortical systems remains elusive. The purpose of this study was to characterizing the CSM-related thalamocortical disturbances, which were associated with spinal cord structural injury, and clinical measures. METHODS: A total of 17 patients with degenerative CSM and well-matched control subjects participated. Thalamocortical disturbances were quantified using thalamus seed-based functional connectivity in two distinct low frequencies bands (slow-5 and slow-4), with different neural manifestations. The clinical measures were evaluated by Japanese Orthopaedic Association (JOA) score system and Neck Disability Index (NDI) questionnaires. RESULTS: Decreased functional connectivity was found in the thalamo-motor, -somatosensory, and -temporal circuits in the slow-5 band, indicating impairment of thalamo-cortical circuit degeneration or axon/synaptic impairment. By contrast, increased functional connectivity between thalami and the bilateral primary motor (M1), primary and secondary somatosensory (S1/S2), premotor cortex (PMC), and right temporal cortex was detected in the slow-4 band, and were associated with higher fractional anisotropy values in the cervical cord, corresponding to mild spinal cord structural injury. CONCLUSIONS: These thalamocortical disturbances revealed by two slow frequency bands inform basic understanding and vital clues about the sensorimotor dysfunction in CSM. Further work is needed to evaluate its contribution in central functional reorganization during spinal cord degeneration.