OBJECTIVETo study the mechanisms of tuina manipulation for treating the dislocation of bone in cervical spondylosis (CS) patients by observing the effects of tuina manipulation on the three-dimensional (3D) angles.

METHODSFrom August to December 2009 20 CS patients were assigned to Group 1 (10 cases, treated with relaxing manipulation) and Group 2 (10 cases, treated with relaxing manipulation and joint regulation). Besides, 10 healthy subjects were recruited as the normal group (treated with relaxing manipulation). Before and after manipulation intervention, all of them were scanned from the base of the skull to the first thoracic vertebra using Philips 64 spiral CT under equal conditions, thus obtaining the volume data. The 0.625 mm thickness was reconstructed using ITK reconstruction software provided by the digital medical laboratory, Software College of Shanghai Jiaotong University. The reconstruction of each cervical skeleton was finished referring to CT data. Changes of the 3D angles were compared among the three groups.

RESULTSThe regulation of the 3D C2 vertebra: Results of Group 2 were significantly larger than those of the normal group at X-, Y-, and Z-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at Z-axis (P < 0.05). The regulation of the 3D C3 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at X-axis (P < 0.05). The regulation of the 3D C4 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). There were no significant difference among the three groups in the 3D spaces of C1, C5, C6, and C7. The larger 3D space was shown in Group 2 than in Group 1 and the normal group.

CONCLUSIONSThe relaxing manipulation combined with joint regulation significantly improved the 3D angles of C2, C3, and C4 in CS patients. The mechanism of tuina manipulation for treating the dislocation of bone in CS patients might lie in adjusting the 3D space of the cervical spine, and improving its functions.