Needle knife therapy for cervical spondylotic radiculopathy: A systematic review and meta-analysis

BACKGROUND: Cervical spondylotic radiculopathy (CSR), a prevalent form of cervical spondylopathy, significantly impacts patients' quality of life. Current management primarily relies on conservative approaches. In recent years, needle knife therapy, as a new type of therapy, has been used in the treatment of CSR. AIM: To evaluate the therapeutic efficacy of needle-knife therapy for CSR and compare its advantages over conventional treatments, including acupuncture, massage, and warm acupuncture. METHODS: Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, PubMed, VIP Chinese Science and Technology Journal Database, China Biology Medicine, and other databases were searched for randomized controlled trials (RCTs) of needle-knife therapy for CSR from the establishment of the database to November 3, 2025. Two independent researchers performed literature screening based on predefined inclusion and exclusion criteria, followed by secondary screening and quality assessment. The Cochrane risk of bias tool was utilized for assessing the methodological quality of the included RCTs. Data synthesis and analysis were performed using RevMan 5.4 software, focusing on treatment effective rates, Visual Analog Scale (VAS) scores, Neck Disability Index (NDI) scores, and Yasushi Tanaka cervical spondylitis symptom scale 20 (YT20) scores. RESULTS: = 84%) scores. Sensitivity analysis did not find significant reversal, indicating that the results of the included studies were reliable. CONCLUSION: Needle-knife therapy for CSR presents a higher efficacy and improved clinical outcome scores when contrasted with conventional treatments. However, these findings are constrained by the generally low quality of the included trials and notable heterogeneity observed in some studies. Consequently, the results should be interpreted with caution and considered preliminary. Further validation through larger, high-quality RCTs is warranted, given the existing limitations in sample size and methodological rigor.