{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:09:39Z","timestamp":1783922979179,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The incidence of cervical spondylotic radiculopathy (CSR) remains high. Conventional conservative treatments have limited efficacy in relieving mechanical nerve root compression, while surgery is highly invasive. Both acupotomy release and ultrasound-guided brachial plexus hydrodissection are minimally invasive interventions for CSR. Nevertheless, high-level multicenter evidence-based medical data regarding the safety and efficacy of their combined application are still lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study enrolled 264 patients with CSR treated at four traditional Chinese medicine hospitals in China between June 2024 and November 2025. The patients were divided into two groups according to the therapeutic regimen: the ultrasound-guided brachial plexus hydrodissection combined with acupotomy release group (HAG) and the ultrasound-guided acupotomy release group (AG). Patients in the AG underwent ultrasound-guided acupotomy release treatment, the target sites for acupotomy release included the C2\/3, C4\/5, and C6\/7 zygapophyseal joints, the C2 spinous process, and the superior medial angles of the bilateral scapulae. Patients in the HAG additionally received ultrasound-guided brachial plexus hydrodissection via the scalene space. Neuroelectrophysiological indicators (F-wave occurrence rate and conduction velocity of the median, ulnar, and radial nerves) were assessed before treatment and at 8\u202fweeks after treatment. he Neck Disability Index (NDI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), and Numeric Rating Scale (NRS) for the brachial plexus traction test were used to evaluate clinical efficacy at baseline and at 4, 8, and 16\u202fweeks after treatment. Adverse events during treatment were simultaneously recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 212 patients with CSR received treatment in this study. During the follow-up period, 3 patients in the HAG were excluded due to self-administered medication and another 3 were excluded due to loss to follow-up; correspondingly, 5 patients in the AG were excluded due to self-administered medication and 2 were excluded due to loss to follow-up. Consequently, 199 patients with CSR were finally enrolled in this study, including 90 cases in the HAG and 109 cases in the AG. At 8\u202fweeks after treatment, the F-wave occurrence rate and conduction velocity of the median, ulnar, and radial nerves were significantly higher in the HAG than in the AG (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The NDI, VAS, and NRS scores for the brachial plexus traction test in the HAG were markedly lower than those in the AG at all postoperative time points (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), whereas the SF-36 score was notably higher (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Both groups of patients experienced transient postsurgical soreness and localized bruising after treatment, no major adverse events, including nerve injury or infection, were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasound-guided brachial plexus hydrodissection combined with acupotomy release is safe and effective in the treatment of CSR. Compared with acupotomy release alone, the combined therapy was associated with greater improvements in neurophysiological parameters, pain severity, upper-limb symptoms, cervical function, and quality of life, thus providing an optimized minimally invasive strategy for the clinical management of CSR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1846209","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:32:45Z","timestamp":1783920765000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided brachial plexus hydrodissection combined with acupotomy release for the treatment of cervical spondylotic radiculopathy: a multicenter retrospective study"],"prefix":"10.3389","volume":"18","author":[{"given":"Xiang","family":"Shang","sequence":"first","affiliation":[{"name":"Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Rui","family":"Luan","sequence":"additional","affiliation":[{"name":"Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]},{"name":"Shuguang Anhui Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Chun","family":"Song","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"San-Bing","family":"Wu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Geng","sequence":"additional","affiliation":[{"name":"Shuguang Anhui Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hou-Shan","family":"Fang","sequence":"additional","affiliation":[{"name":"Lu\u2019an Traditional Chinese Medicine Hospital","place":["Lu'an, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wei","sequence":"additional","affiliation":[{"name":"Fanchang District Traditional Chinese Medicine Hospital","place":["Wuhu, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Ya","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Qing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-Hong","family":"Meng","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Anhui University of Chinese Medicine","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3331024241274266","DOI":"10.1177\/03331024241274266","article-title":"Systematic review and meta-analysis of neck disability index and numeric pain rating scale in patients with migraine and tension-type headache","volume":"44","author":"Al-Khazali","year":"2024","journal-title":"Cephalalgia"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"621150","DOI":"10.3389\/fphar.2020.621150","article-title":"The effectiveness and safety of commonly used injectates for ultrasound-guided hydrodissection treatment of peripheral nerve entrapment syndromes: a systematic review","volume":"11","author":"Buntragulpoontawee","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/BSD.0000000000001681","article-title":"The cervical intervertebral foramen: microanatomy, pathology, and clinical implications","volume":"38","author":"Caballero","year":"2025","journal-title":"Clin. Spine Surg."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13018-023-03508-y","article-title":"Prevalence and morbidity of neck pain: a cross-sectional study of 3000 elderly men","volume":"18","author":"Damm","year":"2023","journal-title":"J. Orthop. Surg. Res."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1093\/pm\/pnaa469","article-title":"Sources of cervicogenic headache among the upper cervical synovial joints","volume":"23","author":"Govind","year":"2022","journal-title":"Pain Med."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"6054","DOI":"10.1016\/j.asjsur.2025.06.066","article-title":"Ultrasound-guided acupotomy release combined with corticosteroid injection for carpal tunnel syndrome: a multicenter retrospective study","volume":"48","author":"Guo-Rui","year":"2025","journal-title":"Asian J. Surg."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1007\/s40122-025-00722-w","article-title":"Efficacy and safety of Mirogabalin in patients with neuropathic pain due to cervical spondylotic radiculopathy: Miro-Cens, a randomized, controlled, interventional study","volume":"14","author":"Hirai","year":"2025","journal-title":"Pain Ther."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.jphys.2020.09.001","article-title":"Clinimetrics: neck disability index","volume":"67","author":"Jones","year":"2021","journal-title":"J. Physiother."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"921","DOI":"10.31616\/asj.2020.0647","article-title":"Cervical radiculopathy focus on characteristics and differential diagnosis","volume":"14","author":"Kang","year":"2020","journal-title":"Asian Spine J."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.15386\/mpr-2507","article-title":"Cervicogenic visual dysfunction: an understanding of its pathomechanism","volume":"96","author":"Leung","year":"2023","journal-title":"Med. Pharm. Rep."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"5717","DOI":"10.2147\/IJGM.S550285","article-title":"Application of acupuncture in cervical spondylotic radiculopathy: an in-depth analysis and outlook on pathophysiological basis and therapeutic mechanisms","volume":"18","author":"Li","year":"2025","journal-title":"Int. J. Gen. Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"81","DOI":"10.14245\/ns.2449086.534","article-title":"Clinical outcomes and patient perspectives in full endoscopic cervical surgery: a systematic review","volume":"22","author":"Liawrungrueang","year":"2025","journal-title":"Neurospine."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1654265","DOI":"10.3389\/fpain.2025.1654265","article-title":"Ultrasound-guided acupotomy for cervical spondylosis: a systematic review and meta-analysis based on GRADE quality assessment","volume":"6","author":"Lijian","year":"2025","journal-title":"Front Pain Res (Lausanne)."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1097\/PHM.0b013e31827d6546","article-title":"The comparison of multiple F-wave variable studies and magnetic resonance imaging examinations in the assessment of cervical radiculopathy","volume":"92","author":"Lin","year":"2013","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2050312116671725","DOI":"10.1177\/2050312116671725","article-title":"SF-36 total score as a single measure of health-related quality of life: scoping review","volume":"4","author":"Lins","year":"2016","journal-title":"SAGE Open Med."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e9115","DOI":"10.7759\/cureus.9115","article-title":"Coexistence of brachial plexus-anterior scalene and sciatic nerve-piriformis variants","volume":"12","author":"Lucas","year":"2020","journal-title":"Cureus."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/s12891-018-2234-0","article-title":"The prevalence and associated factors of symptomatic cervical spondylosis in Chinese adults: a community-based cross-sectional study","volume":"19","author":"Lv","year":"2018","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1097\/AJP.0000000000000999","article-title":"A systematic review and synthesis of psychometric properties of the numeric pain rating scale and the visual analog scale for use in people with neck pain","volume":"38","author":"Modarresi","year":"2021","journal-title":"Clin. J. Pain"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1177\/02692155251365193","article-title":"What components and formats of rehabilitation interventions are more effective to reduce pain in patients with cervical radiculopathy? A systematic review and component network meta-analysis","volume":"39","author":"N\u00fa\u00f1ez de Arenas-Arroyo","year":"2025","journal-title":"Clin. Rehabil."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"73","DOI":"10.5387\/fms.2018-07","article-title":"Comparisons between the efficacy of limaprost alfadex and pregabalin in cervical spondylotic radiculopathy: design of a randomized controlled trial","volume":"64","author":"Onda","year":"2018","journal-title":"Fukushima J. Med. Sci."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"5776","DOI":"10.1016\/j.asjsur.2023.08.138","article-title":"Abdominal acupuncture therapy for cervical spondylotic radiculopathy: a systematic review and metaanalysis","volume":"46","author":"Peng","year":"2023","journal-title":"Asian J. Surg."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e96461","DOI":"10.7759\/cureus.96461","article-title":"Computed tomographic evaluation of the morphometry of the intervertebral foramina and intervertebral discs of the cervical spine","volume":"17","author":"Poudel","year":"2025","journal-title":"Cureus"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2233556","DOI":"10.1080\/07853890.2023.2233556","article-title":"Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial","volume":"55","author":"Pu","year":"2023","journal-title":"Ann. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1097\/BSD.0b013e3181453de4","article-title":"Preservation of the nuchal ligament plays an important role in preventing unfavorable radiologic changes after laminoplasty","volume":"21","author":"Sakaura","year":"2008","journal-title":"J. Spinal Disord. Tech."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1080\/17581869.2025.2494975","article-title":"Dextrose-based Lyftogt perineural injection therapy on facial muscle strength in a bell's palsy patient - a case report","volume":"15","author":"Serrano","year":"2025","journal-title":"Pain Manag."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"EVIDoa2400404","DOI":"10.1056\/EVIDoa2400404","article-title":"Surgical versus nonsurgical treatment for cervical radiculopathy","volume":"4","author":"Taso","year":"2025","journal-title":"NEJM Evid."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e4777","DOI":"10.1002\/ejp.4777","article-title":"Are stabilisation exercises effective after epidural steroid injection in patients with cervical radiculopathy? A prospective randomised controlled trial","volume":"29","author":"Tayboga","year":"2025","journal-title":"Eur. J. Pain"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.17085\/apm.25378","article-title":"Cervical facet joint interventions for neck pain: an anatomically and clinically focused review","volume":"20","author":"Won","year":"2025","journal-title":"Anesth. Pain Med. (Seoul)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1140531","DOI":"10.3389\/fnagi.2023.1140531","article-title":"Qihuang needle therapy in senile cervical spondylotic radiculopathy","volume":"15","author":"Yang","year":"2023","journal-title":"Front. Aging Neurosci."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1698860","DOI":"10.3389\/fneur.2025.1698860","article-title":"Clinical efficacy of ultra-laser irradiation combined with gabapentin on elderly patients with cervical spondylotic radiculopathy","volume":"16","author":"Yu","year":"2025","journal-title":"Front. Neurol."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1846209\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:32:46Z","timestamp":1783920766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1846209\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":30,"alternative-id":["10.3389\/fnagi.2026.1846209"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2026.1846209","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"article-number":"1846209"}}