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KMID : 1129720190360010001
Korean Journal of Acupuncture
2019 Volume.36 No. 1 p.1 ~ p.18
The Effectiveness and Safety of Acupuncture for Recovery of Patients with Vertebral Compression Fractures: A Systematic Review and Meta-analysis
Bae Ji-Min

Lee Myeong-Soo
Choi Ji-Won
Yang Gi-Young
Kim Kun-Hyung
Abstract
Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF).

Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods.

Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD ?1.05 point on a 0 to 10 point scale, 95% CI ?1.45 to ?0.65, I2=74%). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF.

Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.
KEYWORD
acupuncture, vertebral compression fracture, systematic review, low back pain, evidence-based medicine
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