Effects of Cervical Rotatory Manipulation (CRM) on Carotid Atherosclerosis Plaque in Vulnerability: A Histological and Immunohistochemical Study Using Animal Model.

Ji Qi,Yanxiao Xu,Yikai Li,Ruiyue Ping,Kai Wu,Shaoqun Zhang

doi:10.1155/2019/3793840

Abstract

Background The safety of cervical rotatory manipulation (CRM) is still controversial, especially in patients with carotid artery atherosclerosis (CAS). The study aimed to investigate the effects of CRM on carotid plaques in vulnerability. Methods 50 rabbits were randomly divided into four groups: model rabbits with CRM [CAS-CRM (n=15)]; model rabbits without CRM [CAS (n=15)]; normal rabbits with CRM [Normal-CRM (n=10)]; and Blank-control group (n=10). CAS disease models were induced by carotid artery balloon injury combined with a high-fat diet for 12 weeks. Then, CRM technique was performed in CAS-CRM and Normal-CRM groups for 3 weeks. In the end, determination of serum level of hs-CRP and Lp-PLA2, histological analysis under HE and Masson trichromic staining, and immunohistochemical analysis with CD34 and CD68 antibody were completed in order. Results Carotid stenosis rates on successful model rabbits ranged from 70% to 98%. The CAS-CRM group had an increased level of hs-CRP (P<0.05), in comparison with the CAS group, whereas effects were not significant between the Normal-CRM group and Blank-control group. In comparison with the CAS group, the positive expression of CD34 and CD68 in the CAS-CRM group increased significantly (P<0.05). Conclusion CRM therapy may increase the vulnerability of carotid plaque in rabbits with severe CAS.

Highlights

Spine manipulation, one of the complementary and alternative therapies, has been increasingly popular worldwide
Concerning the issues mentioned above, we proposed a hypothesis that cervical rotatory manipulation (CRM) may increase the vulnerability of carotid plaque and even induce plaque ruptures
We found that using a smaller catheter helps to decrease the occurrence of the rupture of rabbit carotid artery during the operation

Summary

Introduction

One of the complementary and alternative therapies, has been increasingly popular worldwide It has been proved effective in the treatment of many diseases [1,2,3]. Others held the opposite opinion that a majority of them may be underreported, most probably since certain complications, such as artery dissection, could remain silent for days or weeks [16]. To date, it is still inconclusive whether CSM should be abandoned for mechanical neck pain [17]. CRM therapy may increase the vulnerability of carotid plaque in rabbits with severe CAS

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Methods

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Conclusion