Efficacy and safety of thread-embedding acupuncture for lumbar herniated intervertebral disc: A systematic review and meta-analysis

Introduction: Thread-embedding acupuncture (TEA) has characteristics that use absorbable medical threads and stimulate tissues and muscles in mechanical and chemical ways. Various studies have proven its therapeutic effect in experimental, as well as clinical trials. However, there remains insufficient evidence to clarify its efficacy and safety for the treatment of lumbar herniated intervertebral disc (LHIVD). Methods: An electronic search for randomized controlled trials that compared the effects of TEA on LHIVD with other conventional treatments from its inception to October 2019 was conducted. Outcome measures were defined as the change in pain intensity and functional status or disability. A quality assessment by the Cochrane's risk of bias tool and a Meta-analysis by Review Manager software was performed. Results: Eighteen articles with 2237 participants were identified. Twelve articles compared the single effect of TEA with other therapy and showed significant improvement in visual analogue scale and curative rates. Six articles compared the added effect of TEA with other single therapies and also showed significant improvement in curative rates. Both single and combined TEA treatments showed significant improvement over other therapy including various types of acupuncture, integrative treatments, herbal medicine, chuna, traction, and injections. There were no reports of serious adverse events. Conclusions: Our results indicated that TEA showed potential benefits on LHIVD. However, it is difficult to draw a conclusion with certainty due to the poor quality of the identified articles. More rigorously designed studies would be needed. Registration PROSPERO (CRD42019133060).