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| Anatomic study of ultrasound-guided acupotomy release of rabbits lumbar ligamentum flavum |
| ZHAO Yu1 GUO Shuang1 CHEN Can1 CHEN Yiren1 DU Mengfan1 NIU Susheng2 LIU Jing3 ZHANG Yan1 |
1.School of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fujian Province, Fuzhou 350122, China;
2.Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fujian Province, Fuzhou 350122, China;
3.the First Department of Bone Traumatology, Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fujian Province, Fuzhou 350004, China
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Abstract Objective To explore the approach of acupotomy release rabbit lumbar ligamentum flavum under ultrasound guidance, according to the anatomical structure of the rabbit lumbar spine and the shape of the ligamentum flavum. Methods The height of spinous process, mastoid process, length, and width of lamina space of L5, L6, and L7 vertebrae in six male New Zealand rabbits aged three months were measured; the six 3-month-old male New Zealand rabbits were measured with the ultrasound probe vertical. The lateral axis of the posterior midline was placed, and the angle between the spinous process and the mastoid process was measured under ultrasound. The longitudinal axis of the ultrasonic probe was placed beside the spinous process to release the ligamentum flavum on both sides of L4/5, L5/6, and L6/7 segments in a plane way the acupotomy insertion depth, insertion angle, the vertical distance from the insertion point to the posterior midline and the vertical distance from the horizontal line of the sacral angle were measured, after the measurement, the data was analyzed and the anatomical structure of acupotomy path was observed. Results There was no significant difference in mastoid hight and spinous process height among L5, L6, and L7 vertebrae (P＞0.05). The length and width of the L5-L7 intervertebral space gradually increased, and the middle part of the yellow ligament was thicker, followed by the medial part, and the lateral part was thinner. There was no significant difference in the angle between spinous process and mastoid process on both sides of L5, L6 and L7 vertebrae measured by ultrasonic transverse axis (P＞0.05). After the longitudinal approach of the needle knife arrived at the yellow ligament under ultrasound guidance, there was no statistical significance in the vertical distance between the insertion points of the left and right sides of the L4/5, L5/6 and L6/7 segments measured after needle retention, the insertion depth of the needle knife, the angle between the needle knife and the horizontal line, namely the insertion angle of the needle knife (P＞0.05). The vertical distance of the horizontal line of the sacral angle at the left and right needle insertion points of L6/7 was shorter than L4/5 and L5/6, and the vertical distance of the horizontal line of the sacral angle at the left and right needle insertion points of L5/6 was shorter than L4/5, the differences were statistically significant (P＜0.05). No obvious blood vessels and nerves were observed in the puncture path, and the dura was intact. Conclusion It is a safe approach to release the rabbit ligamentum flavum with acupotomy when the ultrasound probe is placed parallel to the longitudinal axis. The needle insertion angle should be adjusted according to the anatomical differences of L4/5, L5/6, and L6/7 segments.
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