Protocol for Ultrasound-guided Acupotomy Procedure at Ligament Flavum

Abstract

Background: The aim of this article is to propose the safe and effective protocol for ultrasound-guided acupotomy procedure at ligamentum flavum. Deep needling at the ligament flavum can cause side effects such as leakage of cerebrospinal fluid or hematoma, or exacerbation of the patient's symptoms, which are difficult to respond to in primary medical institutions. In this regard, the need to present a safer and more accurate method of needling at ligamentum flavum is enhanced. Methods: While treating 12 patients aged 60-80 years, the method of needling the shortest length with identifing the tip of acupuncture on the image was studied. An ultrasound machine was used with GE LOGIQ P9 XDclear and C1-6D Single Crystal Convex Probe. The initial study used a SMC 0.40×60 mm needle. After the operation became proficient with the needle, MAANSHAN BOND MEDICAL INSTRUMENTS CO. LTD. GB 60×60 acupotomy was used. Results: A safe procedure method and a manual for education methods were proposed. Conclusion: Because of the long axis entry, the procedure can be performed without missing the full length and tip of the acupuncture on image. It can be performed with small invasion compared to previous in-plane studies performed by laying down the angle.

Current Insights and Updates in Ultrasound-Guided Acupuncture: A Comprehensive Review and Status Report

“…또한 초음파 진단기기에 인공지능이 접목되며 근육 이나 골격의 감별이나 구역화, 초음파 유도하 자입 도구의 강조 영상 획득 등이 시도되고 있으며 75,76) 뿐만 아니라 근골격계 분 야에서도 3D 초음파 등의 도입이 시도되고 있다 77) . 78,79) . 특히 추간공 외부에는 아담키비츠 동맥(artery of Adamkiewicz), 추골 동맥(vetebral artery) 등의 혈관이 존재 하며 때문에 정확하고 안전한 자침을 위해서는 초음파 등을 통 하여 인체 심부를 확인한 후 접근하여야 한다 78,80) .…”