Effectiveness of acupotomy combined with nerve block therapy for cervical radiculopathy: A systematic review and meta-analysis.

Background: This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of combining acupotomy with nerve block therapy (NBT) for cervical radiculopathy (CR) compared to NBT alone.

Methods: A comprehensive search was conducted across multiple databases to identify randomized controlled trials (RCTs) investigating the combined use of acupotomy and NBT for CR. Studies were assessed for risk of bias using the Cochrane Risk of Bias 2 tool. Data were synthesized through meta-analysis where applicable.

Results: Four RCTs with a total of 540 patients were included. Meta-analysis showed that the combination of acupotomy and NBT significantly improved the total effective rate compared to NBT alone (risk ratio 1.16, 95% confidence interval 1.08-1.24, P < .0001). However, no significant pain reduction was observed based on the pain visual analog scale (SMD - 2.55, 95% confidence interval -5.32 to 0.22, P = .07), and there was substantial heterogeneity among the included studies (I² = 99%). The overall risk of bias was high, and safety data were limited, with only one study reporting adverse events.

Conclusion: The findings suggest that acupotomy combined with NBT may enhance treatment effectiveness for CR, particularly in terms of overall therapeutic response. However, due to the high risk of bias, study heterogeneity, and insufficient safety reporting, further well-designed, large-scale RCTs with long-term follow-ups are needed to establish robust clinical evidence.