Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial

Figures & data

Figure 1. Posterior tubercle of the sixth cervical transverse process and selective block C6 nerve root released by injection acupotomy. A. Posterior tubercle of the sixth cervical transverse process was released with injection acupotomy. B. Injection acupotomy selective block C6 nerve root. White arrow. Injection acupotomy; at. Transverse process anterior tubercle of C6; PT. Transverse process posterior tubercle of C6; TP. Transverse process of C6; C6. Nerve root C6; SCMM. Sternocleidomastoid muscle; ASM. Anterior scalene muscle; MSM. Middle scalene muscle.

Figure 2. Posterior tubercle of the seventh cervical transverse process and selective block C7 nerve root released by injection acupotomy. A. Posterior tubercle of the seventh cervical transverse process was released with injection acupotomy. B. Injection acupotomy selective block C7 nerve root. White arrow. Injection acupotomy; PT. Transverse process posterior tubercle of C7; TP. Transverse process of C7; C6. Nerve root C6; C7. Nerve root C7; VA. Vertebral artery; SCMM. Sternocleidomastoid muscle; ASM. Anterior scalene muscle; MSM. Middle scalene muscle.

Table 1. Comparison of demographic and clinical characteristics of subjects in two groups.

	Experimental group (n = 80)	Control group (n = 80)	RD or MD (95% CI)	P value
Age (years) Mean ± SD	55.6 ± 10.5	52.5 ± 11.5	3.125 (−0.301∼6.551)	0.074
Body mass index (kg/m^2) Mean ± SD	23.9 ± 2.5	24.4 ± 2.9	−0.520 (−1.364∼0.324)	0.226
Course of disease (week) M (P25, P75)	2.0 (1.0, 4.0)	2.0 (1.0, 5.0)	0.000 (−1.000∼0.000)	0.581
Sex n (%)
Male	42 (52.5)	41 (51.3)	0.013 (−0.139∼0.163)	0.874
Female	38 (47.5)	39 (48.7)
Degree of education n (%)
Primary school and below	22 (27.5)	21 (26.3)	0.012 (−0.124∼0.148)	0.858
Secondary school	53 (66.3)	54 (67.5)	0.012 (−0.131∼0.155)	0.867
College degree and above	5 (6.2)	5 (6.2)	0.000 (−0.084∼0.084)	1.000
Ethnic group n (%)
Han	76 (95.0)	78 (97.5)	0.025 (−0.044∼0.099)	0.405
Others	4 (5.0)	2 (2.5)
Affected side n (%)
Right	39 (48.8)	37 (46.3)	0.025 (−0.127∼0.175)	0.752
Left	41 (51.2)	43 (53.7)
Cause of disease n (%)
Strain	67 (83.8)	64 (80.0)	0.038 (−0.083∼0.157)	0.538
Stiff neck	9 (11.2)	12 (15.0)	0.038 (−0.070∼0.145)	0.482
Traumatism	4 (5.0)	4 (5.0)	0.000 (−0.078∼0.078)	1.000
Targeted transverse process n (%)
C5	15 (18.8)	17 (21.3)	0.025 (−0.010∼0.149)	0.693
C6	39 (48.7.)	35 (43.7)	0.050 (−0.102∼0.199)	0.526
C7	26 (32.5)	28 (35.0)	0.025 (−0.120∼0.168)	0.738
Number of treatments n (%)
once	45 (56.3)	48 (60.0)	0.037 (−0.113∼0.186)	0.631
twice	35 (43.7)	32 (40.0)

Note: n, number of cases; Mean ± SD, mean ± standard deviation; RD, rate difference; MD, mean difference or median difference; M (P₂₅, P₇₅), median (the first quartile, the third quartile); 95% CI, 95% confidence interval.

Figure 3. Research flowchart.

Table 2. Comparison of efficacy 1 Month and 6 months after the course of treatment of subjects in two groups (ODM).

The clinical curative effect	Experimental group (n = 78)	Control group (n = 79)	RD (95% CI)	P value
1 month after the course of treatment
Excellent n (%)	30 (38.5)	28 (35.4)	–	–
Good n (%)	27 (34.6)	24 (30.4)	–	–
Medium n (%)	13 (16.7)	16 (20.3)	–	–
Poor n (%)	8 (10.2)	11 (13.9)	–	–
The excellent and good rate (%)	73.1	65.8	0.073 (−0.071∼0.212)	0.324
Total effective rate (%)	89.8	86.1	0.037 (−0.069∼0.142)	0.481
6 month after the course of treatment
Excellent n (%)	42 (53.8)	34 (43.0)	–	–
Good n (%)	25 (32.1)	20 (25.3)	–	–
Medium n (%)	6 (7.7)	10 (12.7)	–	–
Poor n (%)	5 (6.4)	15 (19.0)	–	–
The excellent and good rate (%)	85.9	68.4	0.175 (0.044∼0.300)	0.009
Total effective rate (%)	93.6	81.0	0.126 (0.021∼0.232)	0.018

Note: Excellent, Symptoms and signs disappear, can complete daily work and life; good, intermittent mild discomfort, but no obvious impact on work and life, do not need drug treatment; medium, conscious symptoms are improved, but daily activities are still limited, sometimes still need drug treatment; poor, symptoms and signs and function do not improve or even aggravate. n, number of cases; RD, rate difference; 95% CI, 95% confidence interval.

Figure 4. Comparison of VAS score before and after treatment of subjects in two groups.

Figure 5. Comparison of the Neck Disability Index (NDI) before and after treatment of subjects in two groups.

Figure 6. Comparison of SF-36 total score before and after treatment of subjects in two groups.

Figure 7. Picture of injection acupotomy.

Data sharing

The datasets analysed during the current study are available from the corresponding author on reasonable request.