Complementary and Alternative Medicine for the Management of Cervical Radiculopathy: An Overview of Systematic Reviews

Wei, Xu; Wang, Shang-Quan; Li, Jinxue; Gao, Jinghua; Yu, Jie; Feng, Minshan; Zhu, Li

doi:10.1155/2015/793649

Cited by 17 publications

(11 citation statements)

References 39 publications

(43 reference statements)

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“…Meanwhile, the effectiveness of integrative medicine for cervical radiculopathy and neck pain has been receiving wider recognition, giving lead to the recent surge of related studies [23–26]. Unfortunately, most systematic reviews on integrative medicine for CDH and cervical radiculopathy report studies of low or moderate methodological quality [25], demonstrating the need for more definitive evidence generated through well-designed, rigorous clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Survey of Integrative Treatment Practices of Korean Medicine Doctors for Cervical Disc Herniation: Preliminary Data for Clinical Practice Guidelines

Choi

Lee

Kim

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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A survey study was conducted in Korean medicine doctors who provide nonsurgical integrative treatment for cervical disc herniation (CDH) at spine-specialty hospitals to assess usual treatment practices, diagnosis and treatment methods, and related adverse events for CDH. The questionnaire was jointly developed by clinical experts and methodology experts and was administered to 197 Korean medicine doctors (response rate: 84.9% (n = 197/232)) practicing at spine-specialty Korean medicine hospitals for analysis of general sociodemographic information, practice patterns of CDH including diagnosis and treatment strategies, CDH prognosis, and treatment safety. The average clinical experience of respondents was 9.3±6.4 years, and 4.0±1.8 weeks were regarded to be needed for CDH pain to decrease by 50% and 9.1±3.4 weeks to decrease by 80%. Eight-Principle Pattern and Meridian System Identification were the most commonly used Korean medicine syndrome differentiation methods, and CDH was most often considered to be a result of Qi stagnation and Blood coagulation. The Spurling test was reported to be important in physical examination, and magnetic resonance (MR) images were mostly used for diagnosis and treatment of CDH of various diagnostic tools. Treatment mainly consisted of a nonsurgical, integrative multimodal approach comprising acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy. Shinbaro pharmacopuncture and Chungpa-jun, which are well-established herbal treatments supported by evidence, were considered to be of high importance in CDH treatment. With regard to safety, acupuncture was considered to be the safest, while bee venom pharmacopuncture was of highest concern due to potential hypersensitivity. This study is the first report to investigate current practice patterns and approach of Korean medicine doctors to CDH treatment. This data may be of significance to Korean medicine doctors in drawing clinical guidelines and conducting randomized controlled trials (RCTs) to generate high-level evidence on the effectiveness of nonsurgical integrative medicine treatments for CDH.

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Section: Discussionmentioning

confidence: 99%

Survey of Integrative Treatment Practices of Korean Medicine Doctors for Cervical Disc Herniation: Preliminary Data for Clinical Practice Guidelines

Choi

Lee

Kim

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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“…Cervical spinal manipulation (CSM) is one of the important conservative treatments for symptomatic CDH [ 3 – 5 ]. Studies reported that CSM reduces pain in patients with symptomatic CDH [ 6 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Effects of Lateral Bending Position on Performing Cervical Spinal Manipulation for Cervical Disc Herniation: A Three‐Dimensional Finite Element Analysis

Huang

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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Background Most studies report that the common position of cervical spinal manipulation (CSM) for treating symptomatic cervical disc herniation (CDH) is lateral bending to the herniated side. However, the rationality of lateral bending position on performing CSM for CDH is still unclear. Objective The purpose of this study is to investigate the biomechanical effects of lateral bending position on performing CSM for CDH. Methods A finite element (FE) model of CDH (herniated on the left side) was generated in C5-6 segment based on the normal FE model. The FE model performed CSM in left lateral bending position, neutral position, and right lateral bending position, respectively. Cervical disc displacement, annulus fiber stress, and facet joint stress were observed during the simulation of CSM. Results The cervical disc displacement on herniated side moved forward during CSM, and the maximum forward displacements were 0.23, 0.36, and 0.45 mm in left lateral bending position, neutral position, and right lateral bending position, respectively. As the same trend of cervical disc displacement, the annulus fiber stresses on herniated side from small to large were 7.40, 16.39, and 22.75 MPa in left lateral bending position, neutral position, and right lateral bending position, respectively. However, the maximum facet stresses at left superior cartilage of C6 in left lateral bending position, neutral position, and right lateral bending position were 6.88, 3.60, and 0.12 MPa, respectively. Conclusion Compared with neutral position and right lateral bending position, though the forward displacement of cervical disc on herniated side was smaller in left lateral bending position, the annulus fiber stress on herniated side was declined by sharing load on the left facet joint. The results suggested that lateral bending to the herniated side on performing CSM tends to protect the cervical disc on herniated side. Future clinical studies are needed to verify that.

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“…Hence, to get a balanced evaluation of an intervention, we emphasize here the crucial importance of the development of a standardized format for reporting adverse events in SRs. Finally, the methodology and quality of evidence from other SRs on TCM [ 37 – 39 ] were likewise problematic, which may suggest the deficiency of education or training for TCM researchers who conduct SRs and original clinical trials. We strongly recommend that relevant training should be provided to develop the TCM researchers’ consciousness and abilities in designing, conducting, and reporting TCM studies.…”

Section: Discussionmentioning

confidence: 99%

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

et al. 2017

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BackgroundTraditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown.ObjectiveTo summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis.MethodsFive electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach.ResultsTen SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from “very low” to “low,” mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes.ConclusionsTCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

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Complementary and Alternative Medicine for the Management of Cervical Radiculopathy: An Overview of Systematic Reviews

Cited by 17 publications

References 39 publications

Survey of Integrative Treatment Practices of Korean Medicine Doctors for Cervical Disc Herniation: Preliminary Data for Clinical Practice Guidelines

Survey of Integrative Treatment Practices of Korean Medicine Doctors for Cervical Disc Herniation: Preliminary Data for Clinical Practice Guidelines

Biomechanical Effects of Lateral Bending Position on Performing Cervical Spinal Manipulation for Cervical Disc Herniation: A Three‐Dimensional Finite Element Analysis

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

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