Needle knife

Overview

Needle knife therapy, to summarize in comprehensive terms, is a closed release technique situated between surgical intervention and non-surgical treatment modalities. This therapeutic approach integrates the fundamental theories of traditional Chinese medicine with the surgical anatomical principles of Western medicine.

Instrumentation

Specifically developed based on the ancient Chinese Nine Needles while incorporating modern surgical scalpel techniques, needle knife therapy represents an organic integration with soft tissue release procedures. Having evolved over several decades, this therapy has demonstrated a progressive developmental trajectory in recent years. Inspired by Professor Zhu Hanzhang, the pioneer of small needle knife therapy, derivative techniques such as medicated needle knife therapy and hydraulic needle knife therapy have emerged. These advancements have collectively contributed to the formation of a novel theoretical framework in needle knife medicine - a distinct medical system that originates from but transcends conventional Chinese and Western medical paradigms.

Operational Procedures

Needle knife therapy is characterized by its operative technique involving deep insertion into the pathological site through cutaneous puncture, followed by precise cutting and dissection maneuvers to achieve therapeutic objectives of pain relief and pathology resolution.

1.     Position selection follows dual principles of operator accessibility and patient comfort. For cervical interventions, the sitting position is typically employed. Cranial treatments may require either neck extension or flexion positions, determined by lesional topography.

2.     Following site localization, execute three-step sterile preparation: Primary disinfection with 75% medical alcohol. Secondary sterilization with iodine tincture. Final deiodination with alcohol swabbing.

3.     Practitioners must don sterile gloves and reconfirm anatomical landmarks with skin marking. Major joint regions or complex operative sites require additional sterile fenestrated drape application to maintain surgical asepsis.

4.     Local nerve block anesthesia may be administered preoperatively to inhibit nociceptive transmission, particularly for procedures involving hyperalgesic zones.

Therapeutic Advantages

Small needle knife therapy offers distinct clinical benefits characterized by simple operational procedures that require no specific environmental conditions. The treatment involves minimal incisions that eliminate the need for sutures, coupled with negligible tissue damage and low infection risks. Patients typically experience no significant adverse reactions, minimal procedural discomfort, and negligible psychological distress. Postoperative recovery requires no rest period, with each session lasting only brief durations and treatment courses generally completed in short time, resulting in high patient acceptability.

Clinical Applications

The primary indications for small needle knife therapy encompass soft tissue injuries and osteoarticular pathologies:

1.     Cervical Disorders: Cervical muscle strain, cervical disc herniation, cervical osteophytosis, cervical syndrome.

2.     Lumbar Pathologies: Chronic lumbar muscle strain, third lumbar transverse process syndrome, lumbar disc herniation, lumbar osteophytosis, lumbar syndrome, fatigue periostitis, and spinal-related disorders.

3.     Osteoarticular Conditions: Lateral epicondylitis (tennis elbow), stenosing tenosynovitis (trigger finger), calcaneodynia (heel spur), soft tissue injuries, osteochondritis, hypertrophic arthritis.

4.     Soft Tissue Injuries: Chronic soft tissue injuries, acute exacerbation of chronic injuries, and select acute soft tissue trauma.

5.     Inflammatory Disorders: Traumatic bursitis, tenosynovitis, myofascitis

6.     Neuropathic Pain: Peripheral nerve entrapment syndromes, osseofibrous canal compression syndrome.

7.     Multidisciplinary Applications: Selected conditions in internal medicine, orthopedics, proctology, and cosmetic surgery.

Contraindications

1.     Systemic fever and infection, acute exacerbation of severe visceral diseases.

2.     Local inflammation with redness, swelling, heat and pain, and deep tissue necrosis at the procedure site.

3.     Coagulopathies including hemophilia, thrombocytopenia, and clotting factor deficiencies.

4.     Presence of critical neurovascular structures at the target area.

5.     Severe cardiovascular and cerebrovascular disorders.

6.     Active tuberculosis or suspected tubercular lesions.

7.     Malignant neoplasms.

8.     Uncontrolled diabetes mellitus.

9.     Pernicious anemia.

10.  Severe osteoporosis with multiple fractures.

Postoperative Reactions

Pain Migration: Following small needle knife therapy, some patients may experience resolution of original pain accompanied by emergence of secondary discomfort in adjacent areas. At this point, the patient doesn't need to panic. This is because the new painful area has emerged.

Therapeutic Aggravation: Transient exacerbation of preexisting pain constitutes a normal physiological response. reflecting activated tissue repair mechanisms. Pain is a normal manifestation of needle knife therapy and usually disappears within 3 to 5 days.