Effectiveness and safety of ultrasound-guided needle-knife therapy for patients with spinal pain disorders: a systematic review and meta-analysis

Do-Young Kim; Joon-Seok Lee; Sook-Hyun Lee; Yoon Jae Lee; Ju Yeon Kim; In Heo; Jae-Heung Cho; Byung-Kwan Seo; In-Hyuk Ha

doi:10.3389/fmed.2025.1705669

Effectiveness and safety of ultrasound-guided needle-knife therapy for patients with spinal pain disorders: a systematic review and meta-analysis

Front Med (Lausanne). 2025 Dec 5:12:1705669. doi: 10.3389/fmed.2025.1705669. eCollection 2025.

Authors

Do-Young Kim^{1

2}, Joon-Seok Lee¹, Sook-Hyun Lee³, Yoon Jae Lee³, Ju Yeon Kim³, In Heo⁴, Jae-Heung Cho⁵, Byung-Kwan Seo⁶, In-Hyuk Ha³

Affiliations

¹ Department of Acupuncture and Moxibustion, Jaseng Korean Medicine Hospital, Seoul, Republic of Korea.
² Department of Public Health Science, Seoul National University, Seoul, Republic of Korea.
³ Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
⁴ School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea.
⁵ Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
⁶ Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Abstract

Background: Requirements for the development of pre-surgical therapies for spinal pain disorders have arisen, with ultrasound-guided needle-knife therapy (US-NKT) gaining popularity as a minimally invasive treatment. This study aimed to evaluate the clinical outcomes of US-NKT, focusing on its effectiveness and safety.

Methods: A comprehensive literature survey was conducted by using 12 databases to identify randomized controlled trials (RCTs) comparing the effects of US-NKT with control in patients with spinal pain disorders. Characteristics of RCTs were extracted. Also, a meta-analysis of pain and physical function (PF) outcomes was performed at 1-week, 1-month, and 3-month follow-ups. Adverse events (AEs) were also analyzed.

Results: Of the 1,694 articles screened, 23 RCTs (n = 2,107) met the inclusion criteria, with 60.9% addressing spinal degenerative arthropathy. US-NKT significantly reduced pain at 1 week (standardized mean difference [SMD]: -1.11; 95% confidence interval [CI]: -1.42 to -0.79; I² = 73%) and 1 month (SMD: -1.74; 95% CI: -2.50 to -0.98; I² = 95%). However, the effects were not statistically significant at 3 months. PF improved significantly at all time .points, with the strongest effect at 1 week (SMD: -0.92; 95% CI: -1.42 to -0.42; I² = 71%). US-NKT demonstrated superior benefits for pain and PF compared with recommended therapies (at all-time points) or conventional NKT (at 1 week and 1 month). AEs were reported in 43.5% of RCTs, with fewer incidents in the US-NKT groups (4.6%) compared with the controls (13.8%).

Conclusion: US-NKT demonstrates superior efficacy in reducing pain and improving PF compared with recommended therapies or conventional NKT, with a favorable safety profile. However, sustained benefits beyond 3 months remain inconclusive.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024529315.

Keywords: adverse events; minimally invasive treatment; pain reduction; physical function improvement; spinal pain disorders; systematic review and meta-analysis; ultrasound-guided needle-knife therapy.

Publication types

Systematic Review