Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis : A Randomized Clinical Trial.
Study Goal
The researchers aimed to investigate whether acupuncture could improve pain-specific disability in patients with degenerative lumbar spinal stenosis (DLSS) and predominantly neurogenic claudication pain symptoms.
Results Summary
Acupuncture showed a modest reduction in disability scores compared to sham acupuncture, though the difference did not reach the minimal clinically important difference (MCID). The effects appeared to persist for 24 weeks after the 6-week treatment period.
Population
Patients with DLSS and predominantly neurogenic claudication pain symptoms.
Effective Dosage
18 sessions over 6 weeks.
Duration
6 weeks of intervention with 24-week follow-up.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
acupuncture | decrease | modified Roland-Morris Disability Questionnaire (RMDQ) score | Patients with degenerative lumbar spinal stenosis (DLSS) and predominantly neurogenic claudication pain symptoms | from 12.6 to 8.1 | decreased | #1 |
sham acupuncture (SA) | decrease | modified Roland-Morris Disability Questionnaire (RMDQ) score | Patients with degenerative lumbar spinal stenosis (DLSS) and predominantly neurogenic claudication pain symptoms | from 12.7 to 9.5 | decreased | #2 |
acupuncture | decrease | pain-specific disability | patients with DLSS and predominantly neurogenic claudication pain symptoms | - | relieve | #3 |
acupuncture | no change | modified Roland-Morris Disability Questionnaire (RMDQ) score | Patients with degenerative lumbar spinal stenosis (DLSS) and predominantly neurogenic claudication pain symptoms | -1.3 (CI, -2.6 to -0.03) | difference with SA did not reach MCID | #4 |
acupuncture | decrease | pain-specific disability | patients with DLSS and predominantly neurogenic claudication pain symptoms | 24 weeks after 6-week treatment | effects may last | #5 |
BACKGROUND: Acupuncture may improve degenerative lumbar spinal stenosis (DLSS), but evidence is insufficient. OBJECTIVE: To investigate the effect of acupuncture for DLSS. DESIGN: Multicenter randomized clinical trial. (ClinicalTrials.gov: NCT03784729). SETTING: 5 hospitals in China. PARTICIPANTS: Patients with DLSS and predominantly neurogenic claudication pain symptoms. INTERVENTION: 18 sessions of acupuncture or sham acupuncture (SA) over 6 weeks, with 24-week follow-up after treatment. MEASUREMENTS: The primary outcome was change from baseline in the modified Roland-Morris Disability Questionnaire ([RMDQ] score range, 0 to 24; minimal clinically important difference [MCID], 2 to 3). Secondary outcomes were the proportion of participants achieving minimal (30% reduction from baseline) and substantial (50% reduction from baseline) clinically meaningful improvement per the modified RMDQ. RESULTS: A total of 196 participants (98 in each group) were enrolled. The mean modified RMDQ score was 12.6 (95% CI, 11.8 to 13.4) in the acupuncture group and 12.7 (CI, 12.0 to 13.3) in the SA group at baseline, and decreased to 8.1 (CI, 7.1 to 9.1) and 9.5 (CI, 8.6 to 10.4) at 6 weeks, with an adjusted difference in mean change of -1.3 (CI, -2.6 to -0.03; LIMITATION: The SA could produce physiologic effects. CONCLUSION: Acupuncture may relieve pain-specific disability among patients with DLSS and predominantly neurogenic claudication pain symptoms, although the difference with SA did not reach MCID. The effects may last 24 weeks after 6-week treatment. PRIMARY FUNDING SOURCE: 2019 National Administration of Traditional Chinese Medicine "Project of building evidence-based practice capacity for TCM-Project BEBPC-TCM" (NO. 2019XZZX-ZJ).