Xu Xueliang, Ling Yan
Department of Rehabilitation III, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, 610072, People's Republic of China.
Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, 610072, People's Republic of China.
J Pain Res. 2025 Apr 14;18:2035-2045. doi: 10.2147/JPR.S513428. eCollection 2025.
To evaluate the application effects of different manual therapy approaches in the treatment of cervical radiculopathy using a network meta-analysis.
Prospective randomized controlled trials on manual therapy for cervical radiculopathy published in PubMed, the Cochrane Library, and Embase databases were retrieved. The neck disability index and visual analogue scale for neck pain were collected and subjected to network meta-analysis.
A total of 8 eligible studies involving 632 participants with a mean age range of 40-47 years were included. The intervention duration ranged from 4 to 6 weeks. Three intervention groups were defined: Group C (exercise and other therapies without manual therapy), Group M (manual therapy without traction), and Group MT (manual therapy with traction). Larger circles indicate more patients, and thicker lines show more studies comparing interventions. Group M had the highest probability (68.1%) of improving the neck disability index, followed by Group MT (29.1%), with Group C the lowest (2.8%). Compared to Group C, neck disability index scores improved by 0.58 (95% CI: -0.17, 1.33) in Group M and by 0.36 (95% CI: -0.39, 1.11) in Group MT. The difference between Group M and Group MT was not significant (0.22, 95% CI: -0.59, 1.03). For neck pain (visual analogue scale score), Group M had the highest probability (59.5%) of improvement, followed by Group MT (39.6%), with Group C the lowest (0.9%). Compared to Group C, the visual analogue scale score improved by 0.74 (95% CI: -0.04, 1.52) in Group M and by 0.61 (95% CI: -0.18, 1.40) in Group MT. The difference between Group M and Group MT was not significant (0.13, 95% CI: -0.72, 0.98). Egger's regression test showed no apparent publication bias.
Manual therapy is an effective approach for improving neck pain and neck disability index in patients with cervical radiculopathy, but more evidence-based support is needed regarding the use of cervical traction.
采用网状Meta分析评估不同手法治疗方法在神经根型颈椎病治疗中的应用效果。
检索PubMed、Cochrane图书馆和Embase数据库中发表的关于神经根型颈椎病手法治疗的前瞻性随机对照试验。收集颈部功能障碍指数和颈部疼痛视觉模拟量表，并进行网状Meta分析。
共纳入8项符合条件的研究，涉及632名参与者，平均年龄范围为40 - 47岁。干预持续时间为4至6周。定义了三个干预组：C组（运动和其他无手法治疗的疗法）、M组（无牵引的手法治疗）和MT组（有牵引的手法治疗）。圆圈越大表示患者越多，线条越粗表示比较干预措施的研究越多。M组改善颈部功能障碍指数的概率最高（68.1%），其次是MT组（29.1%），C组最低（2.8%）。与C组相比，M组颈部功能障碍指数评分提高了0.58（95%CI：-0.17，1.33），MT组提高了0.36（95%CI：-0.39，1.11）。M组和MT组之间的差异不显著（0.22，95%CI：-0.59，1.03）。对于颈部疼痛（视觉模拟量表评分），M组改善的概率最高（59.5%），其次是MT组（39.6%），C组最低（0.9%）。与C组相比，M组视觉模拟量表评分提高了0.74（95%CI：-0.04，1.52），MT组提高了0.61（95%CI：-0.18，1.40）。M组和MT组之间的差异不显著（0.13，95%CI：-0.72，0.98）。Egger回归检验未显示明显的发表偏倚。
手法治疗是改善神经根型颈椎病患者颈部疼痛和颈部功能障碍指数的有效方法，但在颈椎牵引的使用方面需要更多基于证据的支持。
