Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Abstract

Objective To explore the efficacy and safety of ultrasound-guided injection acupotomy as a minimally invasive intervention treatment of cervical spondylotic radiculopathy (CSR). Methods 160 CSR subjects were recruited who met the inclusion criteria in our hospital from October 2019 to December 2021. The subjects were randomly divided into the experimental and control group, with 80 cases in each. The experimental group received ultrasound-guided injection acupotomy as a minimally invasive intervention therapy. The control group received ultrasound-guided selective nerve root block (SNRB). The Odom’s criteria clinical curative effect, visual analogue scale (VAS), neck disability index (NDI), and 36-Item Short Form Health Survey questionnaire (SF-36) were used to evaluate the outcome of subjects at several different points in time. Results At 30 min and 1 month after the end of treatment, there was no significant difference in any scores. However, after six months, the excellent and good rate was better in the experimental group compared to the control (RD = 0.175; 95% CI, 0.044–0.300, p = 0.009). The total effective rate was also better in the experimental group (RD = 0.126; 95% CI, 0.021–0.232, p = 0.018). In contrast, the VAS score (MD = −0.500; 95% CI, −1.000–0.000, p = 0.030) and NDI score (MD = −6.460; 95% CI, −11.067 to −1.852, p = 0.006) were lower in the experimental group compared to the control. The total SF-36 score was higher in the experimental group (MD = 7.568; 95% CI, 2.459–12.677, p = 0.004). Conclusion Ultrasound-guided injection acupotomy minimally invasive interventional treatment of CSR has no significant difference in short-term curative effect compared with ultrasound-guided SNRB, but the data indicators are significantly better than the latter at 6 months after the end of the course of treatment, showing better long-term efficacy.

Acupotomy in Korean Medicine Doctors: A Preliminary Survey on Experiences, Perceptions, and Clinical Usage Status

“…The needling depth may vary depending on gender, body mass index, and treatment area. The absence of navigational imaging devices may cause serious AEs [ 14 , 15 , 30 ]. Therefore, it is necessary to provide guidelines for safety procedures, including potential AEs based on individual patient characteristics, and procedural guidelines utilizing medical imaging devices, including safe needling depths [ 37 ].…”

“…These studies have encompassed preliminary investigations into pre-procedural safety checks, procedural protocols, and infection prevention measures within the context of the acupotomy procedure, all aimed at fostering a secure environment and refining the acupotomy technique [ 11 , 12 , 13 ]. Furthermore, safety studies using medical imaging equipment such as ultrasound and magnetic resonance imaging have been actively conducted to determine safe needling depths for potentially risky acupuncture points [ 14 , 15 ]. A literature review identified real-world clinical side effects, offering accurate practitioner information [ 2 ].…”

Needle-scalpel therapy inhibits the apoptosis of nucleus pulposus cells via the SDF-1/CXCR4 axis in a rat degenerative cervical intervertebral disc model

“…In the treatment of CS, Ns is used to remove the attached tissues. It protects the cervical intervertebral disc via adjustment of the mechanical features of the soft tissues around the cervical vertebra, relieving stress around the NP and delaying its degeneration [24][25][26]. Our previous study suggested that Ns therapy could inhibit IVDD by modulating the ECM collagen system and improving the altered structure of the NP [27].…”