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Enhanced External Counterpulsation and Traction Therapy Ameliorates Rotational Vertebral Artery Flow Insufficiency Resulting From Cervical Spondylosis

Xin, Wang MD, PhD*; Fangjian, Guo MD*; Hua, Wang MD, PhD*; Jiangtao, Xie MD, PhD*; Shouyi, Wang MM*; Yingchun, Zhao MM*; Xiong, Li MD, PhD†

Spine:
doi: 10.1097/BRS.0b013e3181c62956
Randomized Trial
Abstract

Study Design. Clinical trial of patients with rotational vertebrobasilar insufficiency (VBI) resulting from cervical spondylosis.

Objective. To investigate the effectiveness of enhanced external counterpulsation (EECP) and traction therapy for these patients.

Summary of Background Data. EECP would reduce arterial stiffness and vascular resistance, and increase regional blood flow of vertebral arteries, thus may ameliorate symptoms in these patients.

Methods. One hundred sixty-three patients who were clinically suspected rotational VBI caused by cervical spondylosis were enrolled in this study. They were randomly allocated into 3 groups: EECP + traction, EECP, and traction group. All patients and 50 healthy volunteers received transcranial color Doppler examination of the vertebral artery and basilar artery in both a neutral cervical spine position and a rotational position.

Results. Within 3 days after treatment, 47 (84%) patients in EECP + traction group, 32 (61%) patients in EECP group, and 8 (15%) patients in traction group achieved successful outcomes, while at 3 months' follow-up, 45 (80%) patients in EECP + traction group, 34 (64%) in EECP group, and 3 (6%) in traction group achieved successful outcomes. With head rotation, the percentage of reduction of blood flow velocities of the vertebrobasilar artery (VBA) in patients was much greater than that of the healthy volunteers (P < 0.01). After treatment, rotational blood flow velocity reduction percentage of VBA in each treatment group was much lower than that of each group before treatment. EECP + traction group experienced the greatest decrease of rotational blood flow velocity reduction percentage of VBA, while EECP group experienced second greatest.

Conclusion. EECP and traction therapy can relieve the symptoms of rotational VBI, improve the rotational reduction of vertebrobasilar blood flow, and reduce the increased arterial impedance.

In Brief

Enhanced external counterpulsation (EECP) and traction therapy can relieve the symptoms of rotational vertebrobasilar insufficiency, improve the rotational reduction of vertebrobasilar blood flow, and reduce the increased arterial impedance. The efficacy of EECP + traction therapy is far better than EECP or traction therapy individually, and proves to be effective treatment.

Author Information

From the Departments of *Orthopedics, and †Sonograhy, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan, People's Republic of China.

Acknowledgment date: May 21, 2009. First revision date: August 4, 2009. Second revision date: September 9, 2009. Acceptance date: September 11, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by Health Department of Hubei Province, JX3C17 (to W.X.).

Informed consent has been signed by each patient.

The protocol has been approved by Zhongnan Hospital of Wuhan University, and all experimentation was conducted in conformity with ethical and humane principles of research.

Address correspondence and reprint requests to Wang Xin, MD, PhD, Department of Orthopedics, Zhongnan Hospital of Wuhan University, Donghu Rd 169, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan 430071, People's Republic of China; E-mail: whuwangxin@yahoo.com.cn.

© 2010 Lippincott Williams & Wilkins, Inc.