Acupoint Definition and Clinical Study Analysis for Internal and External Orifices of Intervertebral Foramen Procedures

Introduction: Internal and External Orifices of Intervertebral Foramen (Naegu and Oegu) are important acupoints of acupotomy for lumbar spine diseases.They are used in adhesiolysis of hardened myofascial meridian.Adhesiolysis of soft tissue using acupotomy has been continuously researched abroad, but it has not been well introduced in Korea.Therefore, we provide basic information and acupotomy guidelines about these acupoints.Methods: We presented the surface anatomical definition and acupoint ultrasound image of Oegu and Naegu.Also, we introduced previous research about procedure guidelines and precautions.Finally, we suggested approach guide of Oegu and Naegu.Results: Approach of Oegu starts with inserting acupotomy needle to the root of transverse process (2-3 cm lateral to center of spinous process).Then, change the acupotomy tip to the medial superior direction and enter along the lateral edge of the facet joint.At last, incise soft tissue 2-5 mm.Approach of Naegu starts with inserting acupotomy needle to the medial side of facet joint (0.8-1 mm lateral to interspinous space).Then, incline the acupotomy tip by 10 degrees outward based on the medial edge of the facet joint.At last, enter only 2-5 mm between ligament flavum and the back of the intervertebral foramen and make 2-3 incisions.Conclusion: Accurate locating and needling method are very important for the treatment effect and safe procedure.We suggest using the guidelines presented by us for selecting accurate acupotomy needling point, depth, and direction.