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Effectiveness of Electroacupuncture for Patients with Failed Back Surgery Syndrome: A Systematic Review and Meta-analysis

  • Shin, Donghoon (Department of Acupuncture and Moxibustion, Mokhuri Neck and Back Hospital) ;
  • Shin, Kyungmoon (Department of Acupuncture and Moxibustion, Mokhuri Neck and Back Hospital) ;
  • Jeong, Hwejoon (Department of Korean Medicine Rehabilitation, Mokhuri Neck and Back Hospital) ;
  • Kang, Deok (Department of Korean Medicine Rehabilitation, Mokhuri Neck and Back Hospital) ;
  • Yang, Jaewoo (Department of Acupuncture and Moxibustion, Mokhuri Neck and Back Hospital) ;
  • Oh, Jihoon (Department of Acupuncture and Moxibustion, Mokhuri Neck and Back Hospital) ;
  • Lim, Jinwoong (Department of Acupuncture and Moxibustion, Wonkwang University Gwangju Korean Medicine Hospital)
  • Received : 2022.03.28
  • Accepted : 2022.06.23
  • Published : 2022.08.31

Abstract

Failed back surgery syndrome (FBSS) is a term that applies to symptoms such as persistent or recurring low back pain, paresthesia, sciatica, or numbness after spine surgery. Electroacupuncture (EA) has been reported to have excellent analgesic effects although there have been no systematic reviews on the effects of EA on FBSS. Therefore, a systematic review and meta-analysis of the effectiveness of EA on FBSS was conducted. Eight databases were searched for studies that used EA for FBSS and 7 randomized controlled trials (RCTs) were included. RCTs of EA as combination therapy for FBSS compared with conventional treatment demonstrated improvement in the level of pain, lumbar functional scale scores, and quality of life. However, meta-analysis showed that reduction in pain was not statistically significant, while evaluation of lumbar function significantly improved, although the quality of evidence in the RCTs was generally low. RCTs comparing EA alone with conventional treatment demonstrated an improved level of pain, lumbar function, and effective rate of treatment. Meta-analysis showed that pain was significantly decreased in the EA alone group compared with the control group, although the quality of evidence was low. To improve the quality of evidence, high-quality RCTs are required in the future.

Keywords

Acknowledgement

The study protocol was registered on The International Prospective Register of Systematic Reviews (PROSPERO; registration no.: CRD42022319531)

References

  1. Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin 2007;25:353-371. https://doi.org/10.1016/j.ncl.2007.01.004
  2. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934;211:210-215. https://doi.org/10.1056/NEJM193408022110506
  3. Daniell JR, Osti OL. Failed back surgery syndrome: A review article. Asian Spine 2018;12:372-379. https://doi.org/10.4184/asj.2018.12.2.372
  4. Chan CW, Peng P. Failed back surgery syndrome. Pain Med 2011;12:577-606. https://doi.org/10.1111/j.1526-4637.2011.01089.x
  5. Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K. Long-term outcomes of standard discectomy for lumbar disc herniation: A follow-up study of more than 10 years. Spine 2001;26:652-657. https://doi.org/10.1097/00007632-200103150-00019
  6. Press IASP. Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms, 2nd ed. Seattle (WA): IASP; 1994.
  7. North RB, Campbell JN, James CS, Conover-Walker MK, Wang H, Piantadosi S et al. Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery 1991;28:685-690. https://doi.org/10.1227/00006123-199105000-00008
  8. Christelis N, Simpson B, Russo M, Stanton-Hicks M, Barolat G, Thomson S et al. Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11. Pain Med 2021;22:807-818. https://doi.org/10.1093/pm/pnab015
  9. Petersen EA, Schatman ME, Sayed D, Deer T. Persistent Spinal Pain Syndrome: New Terminology for a New Era. J Pain Res 2021;14:1627-1630. https://doi.org/10.2147/JPR.S320923
  10. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019;160:19-27. https://doi.org/10.1097/j.pain.0000000000001384
  11. Thomson S. Failed back surgery syndrome - definition, epidemiology and demographics. Br J Pain 2013;7:56-59. https://doi.org/10.1177/2049463713479096
  12. Hazard RG. Failed back surgery syndrome: Surgical and nonsurgical approaches. Clin Orthop Relat Res 2006;443:228-232. https://doi.org/10.1097/01.blo.0000200230.46071.3d
  13. Chen YC, Lee CY, Chen SJ. Narcotic addiction in failed back surgery syndrome. Cell Transplant 2019;28:239-247. https://doi.org/10.1177/0963689718796072
  14. Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology 2014;120:482-503. https://doi.org/10.1097/ALN.0000000000000101
  15. Schliessbach J, van der Klift E, Arendt-Nielsen L, Curatolo M, Streitberger K. The effect of brief electrical and manual acupuncture stimulation on mechanical experimental pain. Pain Med 2011;12:268-275. https://doi.org/10.1111/j.1526-4637.2010.01051.x
  16. Cho YH, Kim CK, Heo KH, Lee MS, Ha IH, Son DW et al. Acupuncture for acute postoperative pain after back surgery: A systematic review and meta-analysis of randomized controlled trials. Pain Pract 2015;15:279-291. https://doi.org/10.1111/papr.12208
  17. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021;372:n71.
  18. Jun M-H, Kim Y-M, Kim JU. Modern acupuncture-like stimulation methods: a literature review. Integr Med Res 2015;4:195-219. https://doi.org/10.1016/j.imr.2015.09.005
  19. Hugh M, Douglas G, Richard H, Li Y, Wu T, Adrian W. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): Extending the CONSORT statement. J Altern Complement Med 2010;22:167-180.
  20. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA [Internet]. Cochrane Handbook for Systematic Reviews of Interventions version 6.3. 2022. [cited Mar 2022]. Available from: http://training.cochrane.org/handbook.
  21. Hedges LV, Olkin I. Statistical methods for meta-analysis. Orlando (FL): Academic Press; 1985. p. 1-369.
  22. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-560. https://doi.org/10.1136/bmj.327.7414.557
  23. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-634. https://doi.org/10.1136/bmj.315.7109.629
  24. Schunemann H, Brozek J, Guyatt G, Oxman A [Internet]. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group, 2013. [cited Mar 2022]. Available from: http://guidelinedevelopment.org/handbook.
  25. Heo I, Shin BC, Cho JH, Ha IH, Hwang EH, Lee JH et al. Multicentre randomised controlled clinical trial of electroacupuncture with usual care for patients with non-acute pain after back surgery. Br J Anaesth 2021;126:692-699. https://doi.org/10.1016/j.bja.2020.10.038
  26. Ding X, Sun L, Wang Y, Li Y. Electroacupuncture in the treatment of residual symptoms after transforaminal surgery for lumbar disc herniation. Orthop J China 2020;28:2158-2161. [in Chinese].
  27. Heo I, Hwang MS, Hwang EH, Cho JH, Ha IH, Shin KM et al. Electroacupuncture as a complement to usual care for patients with nonacute low back pain after back surgery: A pilot randomised controlled trial. BMJ Open 2018;8:e018464. https://doi.org/10.1136/bmjopen-2017-018464
  28. Xie K, Xiong L, Chen W, Wu X. Clinical observation on residual symptoms after transforaminal surgery for lumbar disc herniation with electroacupuncture along the lesioned lumbar nerve innervation area. Aerosp Med 2020;31:263-266. [in Chinese].
  29. Cao J [Dissertation]. Clinical analysis of residual symptoms after percutaneous transforaminal surgery with electroacupuncture for lumbar disc herniation. Henan University of Traditional Chinese Medicine; 2018. [in Chinese].
  30. Qi S, Peng K, Pu Z. Efficacy observation of electroacupuncture in the treatment of 40 cases of postoperative low back pain with lumbar disc herniation. Hunan J Tradit Chin Med 2017;33:102-103. [in Chinese].
  31. Xin Z, Cao H, He Y, Qiu M, Zheng X, Shao P. Clinical observation of electroacupuncture at Jiaji point in the treatment of failed lumbar spine surgery syndrome. Liaoning J Tradit Chin Med 2009;36:813-815. [in Chinese].
  32. Statistics Korea, National Health Insurance Corporation [Internet]. Statistics of Surgical Operations & Covered by NHI, Operation by Age/Gender/Type of Opertaion/Type of Medical Institution per 100,000 people (2006-2015). 2017 [cited 30 Mar 2022]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=TX_35004_A015&conn_path=I2.
  33. Inoue S, Kamiya M, Nishihara M, Arai YP, Ikemoto T, Ushida T. Prevalence, characteristics, and burden of failed back surgery syndrome: The influence of various residual symptoms on patient satisfaction and quality of life as assessed by a nationwide Internet survey in Japan. J Pain Res 2017;10:811-823. https://doi.org/10.2147/JPR.S129295
  34. Kim CH, Chung CK, Choi Y, Kim M-J, Yim D, Yang SH et al. The long-term reoperation rate following surgery for lumbar herniated intervertebral disc disease: A nationwide sample cohort study with a 10-year follow-up. Spine 2019;44:1382-1389. https://doi.org/10.1097/BRS.0000000000003065
  35. Kim CH, Chung CK, Park CS, Choi B, Hahn S, Kim MJ et al. Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis: A nationwide cohort study. Spine J 2013;13:1230-1237. https://doi.org/10.1016/j.spinee.2013.06.069
  36. Ye SA, Kim N-K, Song YK. Analysis of medical and Korean medical services utilization after lumbar surgery patients: Using health insurance review and assessment service's patients sample data. J. Korean Med Rehabil 2019;29:89-100. [in Korean]. https://doi.org/10.18325/jkmr.2019.29.4.89