[Improving effects of balanced reduction manipulation for cervical physiological curvature and inflammatory response in patients with vertebroarterial cervical spondylosis].
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OBJECTIVE: To investigate the improving effect of balanced reduction manipulation on cervical physiological curvature and inflammatory response in patients with vertebroarterial cervical spondylosis, so as to provide a reference for clinical treatment planning. METHODS: Between June 2021 and November 2023, a total of 160 patients with vertebral artery-type cervical spondylosis were enrolled and divided into two groups based on treatment modalities:a medication with bone-setting manipulation group and a medication with balance repositioning group. The medication with bone-setting manipulation group included 80 patients (48 males and 32 females), aged from 18 to 64 years with a mean age of(44.87±5.47) years and disease duration ranging from 1 to 24 months with a mean of(10.45±3.11) months. These patients received conventional western medicine therapy along with bone-setting manipulation techniques. The medication with balance repositioning group consisted of 80 patients(47 males and 33 females), aged 18 to 64 years old with a mean age of (44.91±5.44) years old, the disease duration ranged from 1 to 24 monthsn with a mean duration of (10.49±3.08) months. This group was treated with conventional western medicine combined with balance repositioning bone-setting manipulation. Comparative analyses were performed between the two groups regarding primary symptoms including neck and shoulder pain scores, cervical tenderness, limited cervical mobility, upper limb numbness and pain, vertigo severity scores, peak systolic velocity(VP), end-diastolic velocity(VD), cervical physiological curvature (cervical arc-chord distance), neck disability index (NDI), interleukin-4 (IL-4), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), clinical efficacy outcomes, and adverse reactions. RESULTS: The scores for neck and shoulder pain, cervical tenderness, limited cervical mobility, and upper limb numbness pain decreased significantly in both groups after treatment (P<0.05).Post-treatment scores for neck and shoulder pain, cervical tenderness, limited cervical mobility, and upper limb numbness pain in the medication with balance repositioning group were(1.13±0.22), (1.78±0.25), (1.68±0.27), and (0.64±0.14), respectively. The medication with bone-setting manipulation group were (1.95±0.37), (2.36±0.32), (1.91±0.35), and (0.92±0.21), respectively. The difference was statistically significant(P<0.05). Vertigo severity scores improved significantly in both groups after treatment (P<0.05). Notably, the post-treatment score in the medication with Balance repositioning group(13.52±2.04) was significantly higher than that in the medication with bone-setting manipulation group(12.04±1.93), there was statistically significant difference(P<0.05). Both VP and VD increased significantly in both groups (P<0.05). Specifically, the VP and VD values for the vertebral and basilar arteries in the medication with balance repositioning group were (43.64±8.11), (22.50±4.21), (49.44±7.31), and(33.78±4.52) cm·s-1, respectively. These values were significantly higher than those in the medication with bone-setting manipulation group, which were (40.25±7.92), (19.44±3.78), (45.26±6.93), and (30.62±4.11) cm·s-1, respectively(P<0.05). The cervical arc-chord distance increased and the NDI decreased significantly in both groups after treatment (P<0.05). The post-treatment cervical arc-chord distance in the medication with balance repositioning group (9.45±1.70) mm was significantly greater than that in the medication with bone-setting manipulation group(8.26±1.57) mm, there was statistically significant difference(P<0.05). The NDI score was significantly lower in the medication with balance repositioning group (12.52±2.80) than in the medication with bone-setting manipulation group (21.74±3.16), there was statistically significant difference(P<0.05). Post-treatment levels of IL-4 and TNF-αdecreased, while IL-8 levels increased significantly in both groups(P<0.05 ). Specifically, the medication with balance repositioning group exhibited significantly lower levels of IL-4(14.13±1.92) ng·L-1 and TNF-α (11.68±2.07) ng·mL-1 compared to the medication with bone-setting manipulation group (21.95±2.37) ng·L-1 and (13.91±2.35) ng·mL-1, respectively, (P<0.05). The IL-8 level was significantly higher in the medication with balance repositioning group (2.36±0.33) ng·L-1 than in the medication with bone-setting manipulation group (1.78±0.28) ng·L-1, (P<0.05). The total effective rate was significantly higher in the medication with balance repositioning group 93.75%(75/80) than in the medication with bone-setting manipulation group 81.25%(65/80), (P<0.05). In terms of safety, the incidence of adverse reactions was 6.25%(5/80) in the medication with balance repositioning group and 8.75% (7/80) in the medication with bone-setting manipulation group, showing no statistically significant difference between the two groups (P>0.05). CONCLUSION: Balanced reduction manipulation achieves favorable therapeutic effects in patients with vertebroarterial cervical spondylosis. It can effectively relieve clinical symptoms, alleviate vertigo, increase vertebrobasilar artery blood flow velocity, improve cervical physiological curvature and cervical function, and reduce inflammatory responses, and is worthy of clinical application.