A comparative study of a nerve block therapy with and without a deeply inserted acupotomy applied to hyeopcheok points for lumbosacral radiculopathy

Abstract

Introduction:The prevalence of lumbosacral radiculopathy is estimated to be approximately 3% to 5% in patient populations. Lumbosacral radiculopathy is largely caused by a complex interaction between biomechanical and biochemical factors. Nerve block therapy (NBT) mainly treats lumbosacral radiculopathy by improving the biochemical factors, whereas acupotomy mainly focuses on improving the biomechanical factors. Therefore, it is thought that synergistic effects may be obtained for the treatment of lumbosacral radiculopathy when both NBT and acupotomy are combined. However, no study in China and Korea, where acupotomy is majorly provided, has reported the effects of such a combination treatment. Therefore, this study aimed to evaluate the safety, effectiveness, and cost-effectiveness of the concurrent use of a deeply inserted acupotomy and NBT for the treatment of lumbosacral radiculopathy.Methods/design:This is an open-label, parallel, assessor-blinded, randomized controlled trial, which will include 50 patients with lumbosacral radiculopathy. After patients voluntarily agree to participate in the study, they will be screened, and will undergo necessary examinations and tests according to the protocol. Those who satisfy the selection criteria will be randomly assigned to either the NBT + acupotomy or NBT groups in a 1:1 ratio. Both groups will undergo 2 NBTs once every 2 weeks from 1 week after the screening test. The treatment group will receive additional acupotomy twice a week for 4 weeks. The primary endpoint is the Oswestry Disability Index, whereas the secondary endpoints are the Numeral Rating Scale, European Quality of Life 5-dimension, McGill pain Questionnaire, Roland-Morris Disability Questionnaire, safety assessment, and economic feasibility evaluation. The measurements will be made at 0, 2, 4, and 8 weeks.Ethics and dissemination:This trial has received complete ethical approval from the Ethics Committee of Catholic Kwandong University International St. Mary's Hospital (IS20OISE0085). We intend to submit the results of the trial to a peer-reviewed journal and/or conferences.

The Effects of Auricular Acupressure on Low Back Pain, Neuropathy and Sleep in Patients with Persistent Spinal Pain Syndrome (PSPS): A Single-Blind, Randomized Placebo-Controlled Trial

“…These results are similar to the findings of prior studies that reported decreased neuropathy after applying AA to those with cervical spine and spinal cord injuries [21,22]. Postsurgical neuropathy is caused by a pulled spinal nerve due to postsurgical adhesion, ischemia, and obstruction of cerebrospinal fluid flow that nourishes the surrounding nerves [23]. Regarding these causes, it can be said that the reflex point shenmen acts on the central nervous system to control the sensitization of neuropathy, while the reflex points subcortex and sympathetic nerves stimulate the cerebral cortex and the autonomic nervous system to relieve neuropathic pain [11].…”

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

“…Choi et al. [ 38 ] demonstrated how ultrasound-guided acupotomy release combined with nerve block therapy has better curative effects than nerve block therapy alone when treating lumbosacral radiculopathy. Of importance, this procedure is less costly than other methods.…”

Effectiveness of Acupotomy Combined with Epidural Steroid Injection for Lumbosacral Radiculopathy: A Randomized Controlled Pragmatic Pilot Study

“…The protocol of this study was published in March 2022 [23]. This randomized, controlled, two-arm, parallel, assessor-blinded, pragmatic pilot study was conducted at Catholic Kwandong University, International St. Mary's Hospital (CKUH), Incheon, Republic of Korea.…”

“…The incremental cost-utility ratio (ICUR) was calculated to evaluate cost-effectiveness based on the difference in cost and health-related QALYs between the two groups. Specific items for each cost are described in the existing published protocol [23].…”

“…This study aimed to control the pathological chemical substances and relieve mechanical soft tissue compression induced by lumbosacral radiculopathy with the following research hypothesis [23]: the combination of ESI, which has a chemical effect, and acupotomy, which has a mechanical effect, would create a synergy, resulting in better clinical outcomes. This pilot study aimed to evaluate the clinical effectiveness, cost-effectiveness, and safety of deeply inserted acupotomy to EX-B2 acupoints (DAH) combined with ESI for lumbosacral radiculopathy and to examine its feasibility before performing a full-scale main study.…”