Safe Needling Depth of Pungbu(GV16) with MRI-a Retrospective Study

Article information

Acupunct. 2015;32(4):11-16
Department of Acupuncture & Moxibustion medicine, College of Oriental Medicine, Sang-Ji University
*Corresponding author : Department of Acupuncture & Moxibustion Medicine, College of Oriental Medicine, Sang-Ji University, 283, Woosan-dong, Wonju Gangwon, 220-955, Republic of Korea, Tel : +82-33-741-9258, E-mail : redphilips@hanmail.net
Received 2015 October 14; Revised 2015 November 25; Accepted 2015 November 27.

Abstract

Objectives:

The purpose of this study is to determine the safe needling depth of Pungbu(GV16) retrospectively by using magnetic resonance imaging (MRI).

Methods:

We chose 114 Brain or C-spine MRI images from the Sang-Ji hospital picture archiving communication system. We measured the shortest distance from skin to cerebral dura mater passing by posterior edge of the foramen magnum on the sagittal view for the depth of Pungbu. We analyzed the differences between male and female measured values by using a student t-test.

Results:

The average depth of male insertion was 49.71±6.32 mm and the shortest depth of insertion was 36.29 _mm. The average depth of female insertion was 39.84±5.25 mm and the shortest depth of insertion was 30.02 _mm. The results showed a significant difference according to gender (p=0.00).

Conclusions:

The depth of male insertion is deeper than that of female, and the safe needling depth in the case of males is 36.29–67.35 _mm, while the safe needling depth in the of females is 30.02–52.18 mm.

Fig. 1

Flow Chart of the Brain and C-spine Magnetic Resonance Imaging Selection Process

MRI : magnetic resonance imaging

Fig. 2

Needling Depth Measurement of Pungbu(GV16)

A is oblique line connecting cerebral dura mater to skin below external occipital protuberance passing by occipital bone. B is horizontal line connecting cerebral dura mater to skin passing by posterior edge of the foramen magnum. C is perpendicular line from skin to cerebral dura mater passing by posterior edge of the foramen magnum. We chose C as the safe needling depth of Pungbu because C is the shortest distance from skin to cerebral dura mater between the external occipital protuberance and the atlas.

Needling Depth Comparison of Male and Female in Pungbu(GV16)

References

1. The Acupuncture and Moxibustion Textbook Compilation Committee. The Acupuncture & Moxibustion Medicine Seoul: Jipmoondang; 2012. 5p. 293–6. –484.
2. Arne JN, Vinjar F. Acupuncture adverse effects are more than occasional case reports : results from questionnaires among 1135 randomly selected doctors, and 197 acupuncturists. Complement Ther Med 1996;4(1):8–13.
3. Adrian W. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med 2004;22(3):122–33.
4. Yamashita H, Tsukayama H, White AR, Tanno Y, Sugishita C, Ernst E. Systematic review of adverse events following acupuncture : the Japanese literature. Complement Ther Med 2001;9(2):98–104.
5. The Meridians & Acupoints Textbook Compilation Committee. Details of Meridians & Acupoints (Volume II) ; A Guidebook for College Students Wonju: Uibang; 2009. p. 1262–70.
6. Zhang JH, Yan ZG, Yu AS, et al. The safe needling depth in the accidental acupoints. Acupuncture Research 2000;25(3):233–5.
7. Yan ZG, Bai J, Shao SJ, Zhang JH. Study on needling depth and direction for dangerous acupoints. Chinese Acupuncture & Moxibustion 2004;24(11):769–72.
8. Fang JL, Zhang M, Wang YH. Study on safe neeling depth of Fengfu (GV16) with CT. Chinese Acupuncture & Moxibustion 2000;20(12):729–30.
9. Yang SD, Li YD, Jiang GH, Hu NN, Cong SY. Study on neeling depth of Fengfu (GV16) with CT. Chinese Acupuncture & Moxibustion 2008;28(1):47–8.
10. Bai H. Study on acupuncture security of fengfu (DU16) [dissertation] Heilongjiang: Heilongjiang University of Chinese Medicine; 2009. Chinese.
11. Park SJ, Jin M, Joo JC, Kwon YM. Assessment of factors associated with the safety depth of GV15 Yamen : factors associated with the safety depth of GV15. J Pharmacopuncture 2014;17(1):70–3.
12. Netter Frank H. Atlas of Human Anatomy 4th edth ed. Seoul: Jeongdam; 2007. p. 10–1. p. 17–22. p. 100–9. p. 144.
13. Korea Institute of Oriental Medicine. WHO standard acupuncture point locations in the Western Pacific Region Seoul: Elsevier Korea; 2009. p. 215.
14. Micael H, Norbert K, Karl-Heinz C. Handbook of Acupuncture Seoul: Hansol Medical Book; 2010. p. 242–3.
15. An IH, Han GH. Myology Seoul: MDworld; 2011. p. 20–48.
16. Department of Meridian, College of Oriental Medicine. Applied anatomical diagram of acupoints Seoul: Iljungsa; 2000. p. 75. p. 98.
17. Momoshima S. Zettai wakaru MRI no yomikata Seoul: Daehan Medical Book; 2007. p. 26–34.
18. Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Douglas NJ. Neck soft tissue and fat distribution : comparison between normal men and women by magnetic resonance imaging. Thorax 1999;54(4):323–8.
19. Tsukazaki Y, Inagaki T, Yamanouchi Y, Kawamoto K, Oka N. Traumatic subarachnoid hemorrhage associated with acupuncture. Headache 2008;48(8):1240–1.
20. Choo DC, Yue G. Acute intracranial hemorrhage in the brain caused by acupuncture. Headache 2000;40(5):397–8.

Article information Continued

Fig. 1

Flow Chart of the Brain and C-spine Magnetic Resonance Imaging Selection Process

MRI : magnetic resonance imaging

Fig. 2

Needling Depth Measurement of Pungbu(GV16)

A is oblique line connecting cerebral dura mater to skin below external occipital protuberance passing by occipital bone. B is horizontal line connecting cerebral dura mater to skin passing by posterior edge of the foramen magnum. C is perpendicular line from skin to cerebral dura mater passing by posterior edge of the foramen magnum. We chose C as the safe needling depth of Pungbu because C is the shortest distance from skin to cerebral dura mater between the external occipital protuberance and the atlas.

Table 1

Needling Depth Comparison of Male and Female in Pungbu(GV16)

N(%) Mean±SD(mm) Maximum value(mm) Minimum value(mm) p-value*
Male 51(44.7) 49.71±6.32 67.35 36.29 0.00
Female 63(55.3) 39.84±5.25 52.18 30.02
*

p<0.05 by student t-test.