Using magnetic resonance imaging to measure the depth of acupotomy points in the lumbar spine: A retrospective study

Abstract

Background The acupotomy is an acupuncture device recently used to stimulate lumbar vertebrae such as transverse processes (TPs) and facet joints (FJs). However, there are many organs, nerves, and blood vessels, which can lead to side effects if the needle misses the treatment target. Therefore, information regarding appropriate insertion depths, which is currently lacking, could facilitate its safe use. We retrospectively investigated the depth from the skin to the TP and FJ of the lumbar vertebrae, using magnetic resonance imaging (MRI). Methods This retrospective chart review was conducted at a single medical centre in Korea. From 55,129 patient records, 158 subjects were selected. Perpendicular depth from the skin to the left and right TPs and FJs was measured using T1-weighted sagittal plane MRI. Depth differences between the left and right sides were evaluated using the paired t -test and analysis of covariance (body mass index [BMI] as a covariate). The influence of BMI on depth at each location was evaluated by simple linear regression analysis. Results The mean age was 43.2 years and mean BMI was 23.6 kg/m 2 . The depth from skin to the TPs or FJs was unaffected by age, sex, or side. Mean depths (cm) were as follows: (TPs) L1 = 4.5, L2 = 4.9, L3 = 5.3, L4 = 5.7, L5 = 5.9; (FJs) L12 = 3.8, L23 = 4.0, L34 = 4.4, L45 = 4.6, L5S1 = 4.6. Depth was highly correlated with BMI at each location. Conclusion The depth of TPs and FJs adjusted for BMI can safely and effectively be used for treatment via various invasive interventions, including acupotomy treatment, in the lumbar region.

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research

“…For ultrasound OSCE, evaluation tools for abdominal ultrasound [ 38 ] and intensive care ultrasound [ 39 ] have been developed. Ultrasound training is necessary because the safety and effectiveness can be improved by checking the anatomical structures through the ultrasound guide and performing the procedure for the acupuncture, pharmacopuncture, and acupotomy used in traditional medicine [ 14 , 40 , 41 , 42 ]. Therefore, training and assessing students’ performance through the OSCE is essential in traditional medicine education for educational purposes.…”

Effectiveness of Acupotomy Combined with Epidural Steroid Injection for Lumbosacral Radiculopathy: A Randomized Controlled Pragmatic Pilot Study

“…EX-B2 acupoints were used to directly provide physical stimulation to the affected area. Considering that the depth of the L1-5 transverse processes is 45-58 mm, the needle depth was set to within 50-60 mm at the time of perpendicular insertion (Supplemental Table S1) [26].…”