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|Acupuncture versus noninsertive sham acupuncture in ageing patients with degenerative lumbar spinal stenosis: a randomized controlled trial|
|Qin Z, Ding Y, Xu C, Kwong JSW, Ji Y, Wu A, Wu J, Liu Z|
|The American Journal of Medicine 2020 Apr;133(4):500-507.e20|
|9/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
BACKGROUND: Acupuncture is commonly used to treat degenerative lumbar spinal stenosis in Asian countries. However, rigorous data regarding the efficacy and safety of acupuncture for ageing patients is currently lacking. METHODS: Eighty patients older than 50 years were assigned randomly to the acupuncture group or the noninsertive sham acupuncture for 24 treatments over an eight-week period. Measurements were obtained at baseline, 4, and 8weeks of treatment; and 3 and 6months after completion of treatment. The primary outcome was a change in the 24-point Roland Morris Disability Questionnaire (RMDQ) scores at the end of treatment. The secondary outcomes included disability, pain intensity, symptoms and dysfunction. RESULTS: At the end of treatment, mean changes of RMDQ were -4.1 (95% CI -4.9 to -3.3) in the acupuncture group and -1.5 (95% CI -2.3 to -0.7) in the sham group, with a statistically significant between-group difference -2.6 (95% CI -3.7 to -1.4). Acupuncture was superior to sham acupuncture in reducing pain intensity (between-group difference -2.9 (95% CI -3.8 to -2.0) in leg and buttock pain versus -2.3 (95% CI -3.0 to -1.5) in back pain), symptoms and dysfunction (between-group difference -0.9 (95% CI -1.2 to -0.6) in symptom subscale, and-0.8 (95% CI -1.1 to -0.5) in dysfunction subscale). CONCLUSIONS: Acupuncture provide immediate functional recovery and pain relief for degenerative lumbar spinal stenosis. However, current evidence is insufficient to support acupuncture could offer clinical benefits as compared with noninsertive sham acupuncture for degenerative lumbar spinal stenosis.