OBJECTIVES: To observe the clinical efficacy of Tiaokou acupoint-penetrating Chengshan combined with conventional therapy for C5 nerve root palsy after posterior cervical decompression surgery. METHODS: A total of 52 patients undergoing posterior cervical decompression surgery at Tianjin Union Medical Center from March 2020 to March 2023 were grouped using computer-generated random numbers. Group A (n = 26) received the treatment of acupuncture combined with conventional therapy. Group B (n = 26) received only conventional therapy. RESULTS: The VAS scores of the two groups after treatment were significantly lower than scores before treatment (p < 0.01). The JOA scores, Lovett muscle strength grade, and shoulder ROM of the two groups after treatment were significantly higher than those before treatment (p < 0.01). After treatment, the VAS scores of Group A were significantly lower than those in Group B (p < 0.01) while the JOA scores, Lovett muscle strength grade, and shoulder ROM were significantly higher than those in Group B (p < 0.01). There were significant differences in VAS difference (p < 0.01) and JOA difference (p < 0.01) after 2 weeks of intervention treatment in Group A compared to Group B. There was a significant difference in the improvement of shoulder ROM in Group A after 2 weeks of intervention compared to Group B. CONCLUSIONS: The acupuncture method of Tiaokou acupoint-penetrating Chengshan combined with conventional nutritional support therapy was more effective in patients with C5 nerve root palsy after posterior cervical decompression surgery compared to conventional nutritional support therapy. TRIAL REGISTRATION: Clinical Trial Registry identifier: ChiCTR2300073583.

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