Study on Dangerous Acupuncture Needling Depth at Yamen (GV15) for Atlantoaxial Dislocation based on MRI and CT

Background: The depth of acupuncture at GV15 significantly changes with atlantoaxial dislocation (AAD). Magnetic resonance imaging (MRI) and computed tomography (CT) are the current methods for assessing acupuncture depth. However, the acupuncture depth in patients with AAD and the best evaluation method for acupuncture have not been thoroughly studied. Objectives: Based on MRI and 3D CT imaging measurements, dangerous needling depths for perpendicular acupuncture and oblique acupuncture in patients with AAD and normal anatomy were obtained. The application value of MRI and 3D CT in evaluating acupuncture depth is discussed. Methods: From January 2018 to December 2021, patients with AAD (120 patients) and control patients without AAD (124 patients) diagnosed and treated at the Upper Cervical Spine Research Center of the China-Japan Friendship Hospital were selected. All patients were enrolled. Both groups included patients with normal body types (BMI 18.5-23.9). The two groups of patients underwent plain cervical MRI scans and three-dimensional plain CT scans, and the dangerous needling depth of the perpendicular spur and the oblique spur were measured on sagittal images. Results: No significant differences were observed between the two measurements (MRI and CT) (P<0.05). The dangerous needling depths in the AAD group were as follows: male straight stab: 45.33±5.17 mm, male oblique stab: 48.58±4.41 mm, female straight thorn: 44.17±7.80 mm, and female oblique thorn: 47.49±7.32 mm. The dangerous needling depths for the control group were as follows: male straight thorn: 47.72±5.06 mm, male oblique thorn: 42.69±5.53 mm, female straight thorn: 44.63±5.85 mm, and female oblique thorn: 39.88 ± 6.18 mm. Conclusions: Acupuncture depth at the dumb point of the AAD changed significantly. The clinical acupuncture depth should not exceed this safe depth. Both CT and MRI can be used to assess dangerous needling depth at GV15.