Safe needling depths of upper back acupoints in children: a retrospective study

Ma, Yi-Chun; Peng, Ching‐Tien; Huang, Yu‐Chuen; Lin, Hong‐Ping; Lin, Jaung‐Geng

doi:10.1186/s12906-016-1060-x

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Among previous studies on the safe needling depth at GB21, four were carried out using cadavers [ 11 , 12 , 16 , 17 ], one using MRI [ 14 ], one using CT [ 13 ], and one using ultrasonography [ 18 ]. However, only two of these studies focused solely on GB21, and these were both carried out using cadavers [ 12 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, only two of these studies focused solely on GB21, and these were both carried out using cadavers [ 12 , 16 ]. The studies carried out using MRI or CT images were large-scale studies with more than 300 subjects, but the subjects in the study by Ma et al [ 13 ] were aged 4–18 years. Furthermore, MRI and CT cannot consider variables such as respiratory status or posture, and particularly, studies using CT could unnecessarily expose subjects to radiation.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, many researchers have tried to determine the safe needling depth or the risk depth at GB21. However, to date, studies have only been conducted using cadavers [ 11 , 12 ] or CT [ 13 ] and MRI [ 14 ] analyses. Such studies are limited by factors such as cadaveric rigidity, as well as limited postural variation (i.e., supine position only) and the risk of radiation exposure during CT.…”

Section: Introductionmentioning

confidence: 99%

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Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing

Chu

Kim

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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Acupoint GB21 (Jianjing) is used for treating back and shoulder pain but is associated with a risk of pneumothorax. We aimed to determine the SND (safe needling depth) at GB21 according to posture and breathing in real time. Ultrasonographic images of GB21 during normal breathing, inspiration, and expiration in a SP (sitting position) were acquired for 52 healthy volunteers. Images were also acquired during normal respiration in the PP (prone position) with arms raised and lowered. The average SND was greater for men than for women (p < 0.05). Analysis of variance revealed that the SND was greater for the PP than for the SP (p = 0.01 and p < 0.05, resp.). Although the SND tended to change according to posture, the average depth tended to deviate widely in some subjects. During breathing, the differences between inspiration and expiration were less than 1 mm in most subjects, but some showed differences more than 4.5 mm. The SND at GB21 was greater in overweight subjects and significantly greater in the PP and during maximal expiration. However, intragroup differences were greater than the intergroup differences. Therefore, it is dangerous to simply apply needling depth on a gender or BMI basis. The practitioner would adjust the SND by examining the individual anatomical structures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing

Chu

Kim

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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“…Many studies use CT images or magnetic resonance images (MRI) to measure the safe range of depths for concentric needle electrode insertion ( 23 , 24 ). Since a neck CT can clearly display the CP muscle, thyroid, and blood vessels in the neck, we speculate that a safe concentric needle electrode insertion path to the cricopharyngeal muscle can be simulated with the assistance of the patient’s neck CT which clearly marks the angle and depth of concentric needle electrode insertion.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography in measuring electrode insertion angle and depth for cricopharyngeal muscle electromyography

Wu,

Wang,

Zhu

et al. 2023

Quant Imaging Med Surg

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Background Electromyography of the cricopharyngeal muscle (CP-EMG) is one of many assessment tools for dysphagia. The key to performing EMG and BTX injections is to precisely locate the cricopharyngeal muscle with an electrode. One of the main difficulties of electrode insertion is the fact that the CP muscle is located deep within the neck. Since a neck computed tomography (CT) can clearly display the CP muscle, thyroid, and blood vessels in the neck, we speculate that a safe concentric needle electrode insertion path to the cricopharyngeal muscle can be simulated with the assistance of the patient’s neck CT which clearly marks the angle and depth of concentric needle electrode insertion. The purpose of this study was to explore simulated electrode insertion angles and insertion depths for cricopharyngeal electromyography based on retrospective CT data and present a method of percutaneous localization of the cricopharyngeal muscle based on CT images of the neck. Methods One hundred and forty-three neck CT scans performed between January 2019 and November 2020 were included in this study. With the assistance of the angle and straight-line tools found in the Advantage Workstation 4.4 (GE, HealthCare), simulated insertion angles and depths from the anterior border of the sternocleidomastoid muscle to the cricopharyngeal muscle were obtained. Results The 143 CT images originated from participants that included 63 males (44.1%) with an average age of 46.2±13.9 years old. The insertion angle, insertion depth, and neck thickness measured on the CT images were 53.2±10.7˚, 24.2±4.1 mm, and 130.1±17.7 mm, respectively. The insertion angle and depth were significantly greater in males than in females (P<0.05), and the insertion angle increased with the age of participants (P<0.05). A generalized linear model (GLM) showed that insertion angle was positively correlated with neck thickness (β=0.14; 95% CI: 0.03 to 0.25) and gender (β=5.08; 95% CI: 1.31 to 8.85), and negatively correlated with age (β=−5.88; 95% CI: −9.54 to −1.62). Insertion depth was only positively correlated with the neck thickness (β=0.11; 95% CI: 0.07 to 0.15). Conclusions This study indicates that age, gender, and neck thickness are influencing factors for insertion angle, while neck thickness is the influencing factor for insertion depth. The simulated concentric needle electrode insertion method based on CT can assist clinical operation to ensure safety and effectiveness of cricopharyngeal electromyography.

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“…Previous studies have used magnetic resonance imaging 8 , 9 , 10 , 11 , 12 and computed tomography 2 , 9 , 13 , 14 imaging to identify safe depths or angles when needling. However, these imaging modalities are expensive, and in the case of computed tomography, radiographic exposure is required.…”

Section: Introductionmentioning

confidence: 99%

Development of an ultrasound-imaging procedure and acquisition of ultrasound images of acupuncture points for safety and accuracy of needle insertion

Kim

Lee

et al. 2017

Integrative Medicine Research

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BackgroundAcupuncture is a relatively safe, commonly used “alternative” medical treatment for various symptoms. However, adverse effects can occur, including trauma, pneumothorax, and central-nervous-system injury. Our objective was to develop a reliable and practical procedure for ultrasound imaging of acupuncture points to improve safety during needling, and to acquire ultrasound images of several (44) acupuncture points, especially those in high-risk areas, according to an in-house standard operating procedure.MethodsWe created the standard operating procedure for ultrasound imaging for acupuncture, and collected ultrasound images of acupuncture points in clinical trials.ResultsUltrasound images for 44 acupuncture points considered as high-risk points were collected from 85 healthy people who were classified by body-mass index, and high-quality, clear representative images of all 44 points were obtained.ConclusionThese baseline images could be helpful for understanding the anatomy under the skin at acupuncture points, which would allow for an enhanced safety and more accurate needling.

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Safe needling depths of upper back acupoints in children: a retrospective study

Cited by 8 publications

References 19 publications

Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing

Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing

Computed tomography in measuring electrode insertion angle and depth for cricopharyngeal muscle electromyography

Development of an ultrasound-imaging procedure and acquisition of ultrasound images of acupuncture points for safety and accuracy of needle insertion

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