Retrospective study using MRI to measure depths of acupuncture points in neck and shoulder region

Abstract

ObjectivesThere are safety issues associated with acupuncture treatment. Previous studies regarding needling depth of acupuncture points revealed inconsistent results due to vague depth definition, acupuncture point localisation and measuring tools. The objective of this study is to find and compare the differences of the mean depths of 11 acupuncture points in the neck and shoulder region between subjects, with variables including gender and body mass index (BMI).SettingThis study was conducted at a single medical center in Taiwan.ParticipantsThree hundred and ninety-four participants were included in this study. Participants were grouped according to gender and BMI. Acupuncture points were localised by WHO standard and measured by MRI.Outcome measuresThe distance from the needle insertion point (surface of the skin) to any tissues that would cause possible/severe complications.ResultsMean depths of 11 points were obtained in groups of different BMI and gender. Mean depths of all participants regardless of BMI and gender are as follows, in centimetres: GB21=5.6, SI14=5.2, SI15=8.8, GV15=4.9, GV16=4.6, GB20=5.0, ST9=1.6, SI16=1.8, SI17=2.4, TE16=3.1, LI18=1.3. Participants with higher BMI had greater measured depths in both gender groups. Male participants had larger mean depths than female participants regardless of BMI except in SI17 and LI18. When taking BMI into consideration, depths in male participants are greater than in female participants in most of the points except the following: GB21, TE16 in obesity group; ST9 in underweight and obesity group; SI16 in ideal body weight, overweight and obesity group; SI17, LI18 in each group.ConclusionsParticipants with higher BMI had greater measured depths and males tended to have greater depths in most of the points. Clinical practitioners are recommended to consider this information to prevent complications when applying acupuncture treatment to their patients.

Analysis of Traditional Medical Disputes: Data from the Korean Acupuncture and Moxibustion Medicine Society (2013-2017)

“…GB21 is an acupoint near the lung apex and Lee et al [13] reported the distance from the surface of the skin to the thoracic cavity between 3.4 cm and 3.9 cm. Chou et al [14] proposed the safe depth of needling GB21 according to gender and BMI. Depths of 4.0 cm (3.7-3.9 cm) for male underweight patients, 5.3 cm (5.1-5.6cm) for normal-weight patients, 6.4 cm (6.0-6.7 cm) for overweight patients, and 7.1 cm (6.8-7.5 cm) for obese patients were proposed.…”

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

“…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 ].…”

“…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.…”

Ultrasound Detection Acupuncture Needling Training: Description of the Method

“…Among the major acupuncture-related adverse events, pneumothorax is the most severe, and therefore it is crucial that acupuncture practitioners identify safe depths of insertion of acupuncture needles for individual patients. Studies by Professor Lin and colleagues have extensively investigated the safe needle depth [8][9][10][11][12]. In one study of 11 acupuncture points in the neck and shoulder region, they found that the mean depths for the points around the shoulder in all study subjects, regardless of BMI and gender, were as follows: GB21 = 5.6 cm, SI14 = 5.2 cm, and SI15 = 8.8 cm.…”