Acupuncture aids compression fracture recovery. Fujian Provincial Geriatric Hospital (Fuzhou, China) research demonstrates that acupuncture improves recovery following percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Percutaneous vertebroplasty is a type of surgery that involves injecting a medical grade acrylic cement into a fractured vertebra to promote stabilization. The study compared two groups, one received percutaneous vertebroplasty monotherapy and the other received percutaneous vertebroplasty plus acupuncture.
Patients that received acupuncture in addition to percutaneous vertebroplasty experienced a 97.67% clinical effective rate compared with 83.72% in the percutaneous vertebroplasty monotherapy group. [1] Patients receiving acupuncture reported another important outcome. That data shows that patients receiving acupuncture had significantly greater reductions in pain levels.
A total of 86 patients with vertebral compression fractures due to osteoporosis were recruited for the study and were allocated by the random number table method to the acupuncture group or the percutaneous vertebroplasty monotherapy group. The acupuncture group was comprised of 14 male and 29 female patients, ages 59–77 years (mean age 67.2 years), with an osteoporosis duration of 1–10 years (mean duration 6.3 years).
The percutaneous vertebroplasty monotherapy group was comprised of 15 male and 28 female patients, ages 57–76 years (mean age 66.3 years), with an osteoporosis duration of 1–9 years (mean duration 6.1 years). There were no statistically significant differences in baseline characteristics between the two groups at the outset of the investigation.
Selection criteria for the study included a diagnosis of osteoporotic vertebral compression fractures as confirmed by symptoms, bone mineral density, imaging, and examination. Patients were assessed as being suitable for surgery with no psychiatric disorders, met with the hospital’s ethical criteria, and were able to give informed consent. Exclusion criteria were concurrent serious heart, liver, or kidney disease, compression fractures due to conditions other than osteoporosis, fractures older than two weeks or the presence of old fractures as shown by MRI, malignant tumors, or impairment of the circulatory system.
Acupuncture and Surgery
All patients received percutaneous vertebroplasty surgery. If necessary, they received treatment with medications to stabilize blood pressure prior to surgery. The surgical procedure was conducted with patients in a prone position under local anesthesia provided by lidocaine injection. Surgery was performed with the aid of a C-arm fluoroscope to guide the surgeon towards injecting cement into the affected vertebral body. Patients in the acupuncture group received acupuncture treatment at the following primary acupoints:
- Baihui (GV20)
- Mingmen (GV4)
- Dazhui (GV14)
- Yaoyangguan (GV3)
- Zhiyang (GV9)
Secondary acupoints included:
- Qihai (CV6)
- Ciliao (BL32)
- Zusanli (ST36)
- Guanyuan (CV4)
- Sanyinjiao (SP6)
- Pishu (BL20)
- Shenshu (BL23)
Needles were stimulated using a reinforcing method and, after eliciting deqi, were retained for a total of 40 minutes.
Results
Outcome measures for the study included the total clinical effective rate and pain scores as measured by VAS (visual analog scale). The total clinical effective rates were calculated for each group according to back pain symptoms, function in activities of daily life, plus vertebral compression and bone mineral density measurements.
Following treatment, patients with no back pain, normal function in activities of daily life, significantly reduced vertebral compression, and significantly improved bone mineral density were classified as recovered. For patients with significant reductions in back pain, normal function in activities of daily life, reductions in vertebral compression compared with pre-treatment levels, and improved bone mineral density, the treatment was classified as effective. For patients with residual back pain, impaired functionality, and no significant changes in bone mineral density, the treatment was classified as ineffective.
In the acupuncture group, there were 24 recovered and 18 effective cases, with 1 ineffective case, yielding a total clinical effective rate of 42/43 (97.67%). In the percutaneous vertebroplasty monotherapy group, there were 15 recovered, 21 effective, and 7 ineffective cases, yielding a total clinical effective rate of 36/43 (83.72%).
Pain scores were measured using a VAS of 0–10, with higher scores indicative of increased pain. VAS scores were measured prior to treatment and at 7 and 30 days post-treatment. Mean pre-treatment VAS scores in the acupuncture group were 8.44, falling to 4.31 at 7 days and 2.58 at 30 days post-treatment. Mean pre-treatment VAS scores in the percutaneous vertebroplasty monotherapy group were 8.32, falling to 6.26 at 7 days and 4.17 at 30 days post-treatment. Patients in the acupuncture group experienced significantly greater improvements in pain reduction at both post-treatment assessments.
The results of this study indicate that acupuncture aids recovery after percutaneous vertebroplasty in patients with osteoporosis related fractures. Benefits of acupuncture include improving local circulation to promote efficient healing, reducing swelling and inflammation, and significantly relieving pain. The data indicates that an integrative model of patient care combining acupuncture with percutaneous vertebroplasty optimizes positive patient outcome rates.
Reference:
1. Liu Gang (2019) “Clinical study of percutaneous vertebroplasty combined with acupuncture in the treatment of osteoporotic vertebral compression fractures” Journal of Integrated Traditional Chinese and Western Medicine Vol.23 (28) pp.4111-4112.
