title: Safe needling depths of upper back acupoints in children: a retrospective study.
abstract: BACKGROUND
  Acupuncture is applied for treating numerous conditions in children, but few studies have examined the safe needling depth of acupoints in the pediatric population. In this study, we investigated the depths to which acupuncture needles can be inserted safely in the upper back acupoints of children and the variations in safe depth according to sex, age, weight, and body mass index (BMI).
  
  
  METHODS
  We retrospectively studied computed tomography (CT) images of patients aged 4 to 18 years who underwent chest CT at China Medical University Hospital between December 2004 and May 2013. The safe depths of 23 upper back acupoints in the Governor Vessel (GV), Bladder Meridian (BL), Small Intestine Meridian (SI), Gallbladder Meridian (GB) and Spleen Meridian (SP) were measured directly from the CT images. The relationships between the safe depths of these acupoints and sex, age, body weight, and BMI were analyzed.
  
  
  RESULTS
  The results indicated significant differences in safe needling depth between boys and girls in most upper back acupoints, except at BL42, BL44, BL45, BL46, GB21 and SP21. Safe depths differed significantly depending on age (p < 0.001), weight (p ≤ 0.01), and BMI (p < 0.05). Multiple regression analysis revealed that weight was the most crucial factor in determining the safe depth.
  
  
  CONCLUSIONS
  Sex, age, weight, and BMI are relevant factors in determining the safe needling depths of upper back acupoints in children. Physicians should pay attention to wide variations in needle depth when performing acupuncture.
authors.affiliation: Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, ROC. yichun.mail@gmail.com.|Department of Pediatrics, Tai-An Hospital, Taichung, Taiwan. yichun.mail@gmail.com.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Ma
authors.affiliation: Children's Hospital of China Medical University, Taichung, Taiwan, ROC. pct@mail.cmuh.org.tw.
authors.forename: Ching-Tien
authors.initials: CT
authors.lastname: Peng
authors.affiliation: School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, ROC. yuchuen@mail.cmu.edu.tw.|Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC. yuchuen@mail.cmu.edu.tw.
authors.forename: Yu-Chuen
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Children's Hospital of China Medical University, Taichung, Taiwan, ROC. rad.potz@gmail.com.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, ROC. jglin@mail.cmu.edu.tw.|China Medical University, No.91, Xueshi Rd., North Dist., Taichung City, 40402, Taiwan, ROC. jglin@mail.cmu.edu.tw.
authors.forename: Jaung-Geng
authors.initials: JG
authors.lastname: Lin
mesh_terms: D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000009:adverse effects; D000293:Adolescent; D001415:Back; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D061214:Patient Safety; D010372:Pediatrics; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed