Efficacy and safety of acupuncture combined with bone-setting in the treatment of cervical vertigo: A systematic review and meta-analysis.

OBJECTIVES

In this meta-analysis, we aimed to evaluate systematically the effectiveness and safety of acupuncture combined with bone-setting in the treatment of cervical vertigo (CV).

MATERIALS AND

METHODS

A systematic search was conducted across three English databases (PubMed, the Web of Science and the National Library of Medicine) and two Chinese databases (the China National Knowledge Infrastructure and the Wanfang Database). The search timeframe spanned from the inception of each database until 31 January 2025. The search terms were as follows: (i) 'Bone-setting' OR 'Bone Setting' OR 'Chinese Osteopathy' OR 'Chiropractic manipulation'; (ii) 'Acupuncture and Moxibustion' OR 'Acupuncture' OR 'Traditional Chinese acupuncture' OR 'Electroacupuncture' OR 'fire acupuncture' OR 'warm acupuncture'; (iii) 'Cervical Vertigo' OR 'Vertebral Artery Cervical Spondylosis' OR 'CV'.

RESULTS

A total of 15 articles were included, all of which were randomized-controlled trials (RCTs), involving 2,320 participants. The meta-analysis results showed that, compared to using acupuncture alone or bone-setting alone for CV, the combined therapy demonstrated a significantly higher overall clinical efficacy rate (odds ratio [OR]=3.88, 95% confidence interval [CI]: 2.89, 5.19, p<0.001), significantly better symptoms and functional assessment scores for CV (mean difference [MD]=4.01, 95% CI: 3.19, 4.83, p<0.001), significantly better mean flow velocity (Vm) in the vertebral artery (MD=3.21, 95% CI: 1.58, 4.84, p<0.001), significantly better Vm in the basilar artery (MD=5.09, 95% CI: 0.78, 9.40, p=0.02) and better quality of life scores (MD=9.83, 95% CI: 5.89, 13.77, p<0.001).

CONCLUSION

Acupuncture combined with bone-setting may be superior to monotherapy in improving symptoms, function and cerebral blood flow in patients with CV, with fewer and milder adverse effects. However, due to the limited methodological quality of the included studies, more high-quality, large-sample RCTs are needed to further validate these results.