Korean Journal of Acupuncture

Society for Meridian and Acupoint (경락경혈학회)
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The Effectiveness and Safety of Acupuncture for Recovery of Patients with Vertebral Compression Fractures: A Systematic Review and Meta-analysis

척추 압박 골절 환자의 회복에 대한 침 치료의 유효성 및 안전성 평가: 체계적 문헌 고찰과 메타분석

  • Bae, Ji min (Samse Korean Medicine Clinic) ;
  • Lee, Myeong su (Korea Institute of Oriental Medicine) ;
  • Choi, Ji won (Department of Acupuncture & Moxibustion Medicine, Pusan National University Korean Medicine Hospital) ;
  • Yang, Gi young (Department of Acupuncture & Moxibustion Medicine, Pusan National University Korean Medicine Hospital) ;
  • Kim, Kun hyung (Department of Acupuncture & Moxibustion Medicine, Pusan National University Korean Medicine Hospital)
  • 배지민 (삼세한의원) ;
  • 이명수 (한국한의학연구원) ;
  • 최지원 (부산대학교한방병원 침구의학과) ;
  • 양기영 (부산대학교한방병원 침구의학과) ;
  • 김건형 (부산대학교한방병원 침구의학과)
  • Received : 2018.11.28
  • Accepted : 2019.01.24
  • Published : 2019.03.27
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Abstract

Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

Keywords

References

  1. Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone. 1995 ; 17(5 Suppl): 505s-11s.doi: 10.1016/8756-3282(95)00258-4.
  2. Schousboe JT. Epidemiology of Vertebral Fractures. J Clin Densitom. 2016 ; 19(1) : 8-22. doi: 10.1016/j.jocd.2015.08.004.
  3. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006 ; 17(12) : 1726-33. doi: 10.1007/s00198-006-0172-4.
  4. Pluijm SM, Tromp AM, Smit JH, Deeg DJ, Lips P. Consequences of vertebral deformities in older men and women. J Bone Miner Res. 2000 ; 15(8) : 1564-72. doi: 10.1359/jbmr.2000.15.8.1564.
  5. Esses SI, McGuire R, Jenkins J, Finkelstein J, Woodard E, Watters WC 3rd, et al. The treatment of symptomatic osteoporotic spinal compression fractures. J Am Acad Orthop Surg. 2011 ; 19(3) : 176-82. doi: 10.5435/00124635-201103000-00007.
  6. Giangregorio LM, Macintyre NJ, Thabane L, Skidmore CJ, Papaioannou A. Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev. 2013 ; 1 : Cd008618. doi: 10.1002/14651858.CD008618.pub2.
  7. Buchbinder R, Johnston RV, Rischin KJ, Homik J, Jones CA, Golmohammadi K, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2018 ; 4 : Cd006349. doi: 10.1002/14651858.CD006349.pub3.
  8. Bae JM, Kim DH, Kim JK, Lee BR, Yang GY, Kim KH. Korean Medicine for Thoracolumbar Compression Fracture in Korean Literature: a Systematic Review. The Acupuncture. 2015 ; 32(4) : 147-56. doi: 10.13045/acupunct.2015069.
  9. Kim DE, Kim JH, Joung JS, Yu SA, Cho SW. A Review of Recent Studies for Treatment of Compression Fracture Using CNKI Database. J Korean Med Rehabi. 2017 ; 27(3) : 1-12. doi: 10.18325/jkmr.2017.27.3.1.
  10. Witt CM, Linde K. Clinical research in complementary and integrative medicine. Elsvier. 2013 : 13, 19-38.
  11. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R, et al. Standards for reporting interventions in controlled trials of acupuncture: The STRICTA recommendations. STandards for Reporting Interventions in Controlled Trails of Acupuncture. Acupunct Med 2002 ; 20(1) : 22-5. doi: 10.1054/caom.2001.0114.
  12. Higgins, GS J. Cochrane handbook for systematic reviews of interventions.version5.0.2. The Cochrane Collaboration 2009 : 187-241. doi: 10.1002/9780470712184.
  13. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul : National Evidence-based Healthcare Collaborating Agency. 2011 : 1-271.
  14. Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
  15. Zhou HW, Qiu Y. Acupuncture for gastrointestinal dysfunction caused by thoracolumbar compression fracture. Chinese acupuncture and moxibustion 2000 : 1 : 7-8.
  16. Cao H. The influence of electro-acupuncture on Jiaji points on the functional rehabilitation of elderly person with thoracolumbar compression fracture [[Master's degree]], 2009.
  17. Hwnag G, Chen P, C H. Abdominal acupuncture for constipation after osteoporotic thoracolumbar compression fracture operation surgery. Journal of New Chinese Medicine. 2011 : 3.
  18. Jin HB, Si XD. Small Needle Knife for Treatment of Thoracolumbar Compression Fractures in 37 Cases. Zhejiang Journal of Traditional Chinese Medicine. 2012 ; 3 : 200.
  19. Zhang G. Acupuncture for Osteoporotic Lumbar Vertebral Compression Fracture : 23 cases. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2013 ; 2.
  20. Hwang WB. Balance-acupuncture for low back pain caused by lumbar vertebral compression fracture. Journal of New Chinese Medicine. 2013 : 5.
  21. Jiang T. Intensive silver needle combined with zoledronic acid for the treatment of osteoporotic back pain. Jiangsu Medical Journal. 2014 ; 20(40).
  22. Chen HQ. Clinical observation of silver needle combined with calcitonin in the treatment of osteoporosis and low back pain. Journal of North Pharmacy. 2014 ; 12.
  23. Zhang W, Qui X, W J. Clinical study on abdominal acupuncture for osteoporotic vertebral compression fracture. Journal of Acupuncture and Tuina Science. 2015 ; 13(4) : 225-59.
  24. Zeng Z. Zhengqing Fengtongning combined with Danshen injection for lumbar vertebral compression fracture : 62 cases. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2015 : 14.
  25. Schiller J, Korallus C, Bethge M, Karst M, Schmalhofer ML, Gutenbrunner C, et al. Effects of acupuncture on quality of life and pain in patients with osteoporosis-a pilot randomized controlled trial. Arch Osteoporos. 2016 ; 11(1) : 34. doi: 10.1007/s11657-016-0288-x.
  26. Wang QX. Embedding Therapy Intradermal Needle Therapy Acupoint Sticking Therapy Constipation Spinal Fractures. Journal of Acupunctrue and Tuina Science. 2016 ; 3(14) : 207-10. https://doi.org/10.1007/s11726-016-0926-2
  27. Wang G, Long XY, Liu LJ, Liu H. Effect of Warm Needling Moxibustion on Bone Density, BGP and IL-6 in Osteoporotic Compression Fracture. Shanghai Journal of Acupuncture and Moxibustion. 2017 ; 12(36) : 1455-8.
  28. Wang LQ. Treatment of over 80 year old patients with osteoporotic spinal fractures by small needle knife. Guide of China Medicine. 2017 : 35 : 202-3.
  29. Yu Y. Needle knife treatment for thoracolumbar compression fracture pain : 65 cases. Chinese Journal of Traditional Medical Science and Technology. 2015 : 3 : 333.
  30. Zhang Y, Guan YY, Li LC, Huang S, Guo J, Yu XY. Radiofrequency combined with silver needle for treatment of osteoporotic thoracolumbar compression fracture. Chinese Journal of Pain Medicine. 2016 ; 3 : 232-4.
  31. Yang H. Small needle knife for thoracolumbar compression fractures. World Latest Medicine Information. 2017 ; A1 : 218.
  32. Liu BX, Wang LP, Xu M, Huang CJ, Tang FY, Lou YM, et al. Small needle knife in treating patients with back pain caused by osteoporotic vertebral fracture over Age 80. Chinese Journal of Gerontology. 2011 ; 19 : 3811-2.
  33. Lau RKW, Lau TFO, Cheng CPY, Law SW, Fung KY. A double-blinded and randomized controlled trial for the effectiveness of electro-acupuncture for the management of signs and symptoms associated with collapse of spine. Hong Kong Physiotherapy Journal. 2011 ; 29(2) : 100.
  34. Yang C. Effect of small needle knife in treatment of back pain in elderly osteoporotic vertebral fractures. Chinese Manipulation and Rehabilitation Medicine. 2016 ; 6 : 35-6.
  35. Cao H, Shao P, Liu XY. The effect of electro-acupuncture at Jiaji acupoint on functional rehabilitation of middle-aged and aged patients with thoracolumbar fracture. People's Military Surgeon. 2013 ; 04 : 420-2.
  36. Schulz KF, Grimes DA. Allocation concealment in randomised trials: defending against deciphering. Lancet. 2002 ; 359(9306) : 614-8. doi: 10.1016/s0140- 6736(02)07750-4.
  37. Furuse N, Shinbara H, Uehara A, Sugawara M, Yamazaki T, Hosaka M, et al. A Multicenter Prospective Survey of Adverse Events Associated with Acupuncture and Moxibustion in Japan. Med Acupunct. 2017 ; 29(3) : 155-62. doi: 10.1089/acu.2017.1230.
  38. White A, Hayhoe S, Hart A, Ernst E. Survey of adverse events following acupuncture (SAFA): a prospective study of 32,000 consultations. Acupunct Med. 2001 ; 19(2) : 84-92. doi: 10.1111/j.2042-7166.2001.tb02846.x.
  39. White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004 ; 22(3) : 122-33. doi: 10.1136/aim.22.3.122.

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