Feasibility, Safety, and Effectiveness of Ultrasound-Guided Acupotomy Treatment for Degenerative Cervical Radiculopathy: A Pilot Randomized Controlled Trial.

PURPOSE: To assess the feasibility, safety, and effectiveness of ultrasound-guided acupotomy (UA) compared with conventional physical therapy (CPT) in patients with degenerative cervical radiculopathy (CR).

PATIENTS AND

METHODS

Thirty-two participants with clinically and radiologically confirmed CR were randomized to receive UA or CPT (interferential current therapy+microwave diathermy). Interventions were delivered twice weekly for 3 weeks, followed by an 8-week follow-up with assessments at weeks 4, 7, and 11. The outcomes included the visual analog scale (VAS) for neck and arm pain, painDETECT, Neck Disability Index (NDI), Depression Anxiety Stress Scale-21 (DASS-21), clinically important differences (CID), EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L), and Patient Global Impression of Change. Adverse events (AEs) were assessed at every visit.

RESULTS

The overall treatment adherence rate was 96.9%, with 100% treatment completion in the UA group. Acupotomy-related AEs occurred in 5 of the 96 treatment sessions (5.21%), all of which were mild and self-limiting. The UA group showed preliminary evidence of greater improvements in VAS scores for arm and neck pain or discomfort, painDETECT, NDI, CID, and PGIC compared with the CPT group at all time points. At week 4, adjusted mean differences favored UA by 25.7 mm for neck and 18.7 mm for arm VAS. For the DASS-21, between-group differences were observed for depression and stress at week 4. The UA group showed preliminary evidence of greater improvements in EQ-5D-5L scores at weeks 4 and 7 compared with the CPT group.

CONCLUSION

This pilot study suggests that UA is a feasible and safe treatment option for degenerative CR, with preliminary effects on pain intensity, functional disability, neuropathic pain characteristics, psychological distress, and health-related quality of life, compared to CPT. These findings warrant confirmatory studies with larger sample sizes.