Acupuncture for lumbar spinal stenosis: a systematic review and meta-analysis.
OBJECTIVE
Lumbar spinal stenosis (LSS) negatively affects patients' quality of life. No systematic review evaluating the effects and safety of acupuncture for this population is available. We aimed to evaluate evidence indicating the effectiveness and safety of acupuncture for LSS.


METHODS
We searched five English-language databases (EMBASE, MEDLINE, CENTRAL, CINAHL, and AMED) and one Chinese database (CAJ) for randomised controlled trials (RCTs) and non-randomised controlled clinical trials (CCTs) of needle acupuncture for LSS. CCTs were analyzed only in terms of safety and intervention-related information.


RESULTS
Six RCTs (n=582) and six CCTs, which were all from China and reported in Chinese, were included. High or uncertain risk of bias and clinical heterogeneity due to different acupuncture techniques were observed. All RCTs compared different combinations or techniques of acupuncture. None of the included studies mentioned safety issues. Acupuncture combined with other interventions and/or with additional stimulation increased the number of improved patients compared with acupuncture alone or relatively simpler stimulation (n=582; relative risk, 1.16; 95% confidence interval 1.08-1.25). Pain intensity, overall symptoms, and functional outcomes related to LSS and quality of life showed significantly favourable improvement in the treatment group compared with the control group, which lasted for up to 6 months post-treatment.


CONCLUSIONS
We found no conclusive evidence of the effectiveness and safety of acupuncture for LSS because of high or uncertain risk of bias and the limited generalisability of the included studies. Future trials using rigorous methodology, appropriate comparisons and clinically relevant outcomes should be conducted.
Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea; Department of Acupuncture and Moxibustion Medicine, Korean Medicine Hospital, Pusan National University, Yangsan, South Korea.
Kun Hyung
KH
Kim
Tae-Hun
TH
Kim
Byung Ryul
BR
Lee
Jae Kyu
JK
Kim
Dong Wuk
DW
Son
Sang Weon
SW
Lee
Gi Young
GY
Yang
D015670:Acupuncture Therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013130:Spinal Stenosis / Q000628:therapy*; D016896:Treatment Outcome
Acupuncture; Complementary and alternative medicine; Lumbar spinal stenosis; Systematic review