Acupuncture for lumbar spinal stenosis: A systematic review and meta-analysis.
Author: Kim KH, Kim TH, Lee BR, Kim JK, Son DW, Lee SW, Yang GY.
Affiliation:
Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea; Department of Acupuncture and Moxibustion Medicine, Korean Medicine Hospital, Pusan National University, Yangsan, South Korea.
Conference/Journal: Complement Ther Med.
Date published: 2013 Oct
Other:
Volume ID: 21 , Issue ID: 5 , Pages: 535-56 , Special Notes: doi: 10.1016/j.ctim.2013.08.007 , Word Count: 266
OBJECTIVES:
Lumbar spinal stenosis (LSS) negatively affects patients' quality of life. No systematic review evaluating the effects and safety of acupuncture for this population is available. We aimed to evaluate evidence indicating the effectiveness and safety of acupuncture for LSS.
METHODS:
We searched five English-language databases (EMBASE, MEDLINE, CENTRAL, CINAHL, and AMED) and one Chinese database (CAJ) for randomised controlled trials (RCTs) and non-randomised controlled clinical trials (CCTs) of needle acupuncture for LSS. CCTs were analyzed only in terms of safety and intervention-related information.
RESULTS:
Six RCTs (n=582) and six CCTs, which were all from China and reported in Chinese, were included. High or uncertain risk of bias and clinical heterogeneity due to different acupuncture techniques were observed. All RCTs compared different combinations or techniques of acupuncture. None of the included studies mentioned safety issues. Acupuncture combined with other interventions and/or with additional stimulation increased the number of improved patients compared with acupuncture alone or relatively simpler stimulation (n=582; relative risk, 1.16; 95% confidence interval 1.08-1.25). Pain intensity, overall symptoms, and functional outcomes related to LSS and quality of life showed significantly favourable improvement in the treatment group compared with the control group, which lasted for up to 6 months post-treatment.
CONCLUSIONS:
We found no conclusive evidence of the effectiveness and safety of acupuncture for LSS because of high or uncertain risk of bias and the limited generalisability of the included studies. Future trials using rigorous methodology, appropriate comparisons and clinically relevant outcomes should be conducted.
Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:
Acupuncture, Complementary and alternative medicine, Lumbar spinal stenosis, Systematic review
PMID: 24050593
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