{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:44:46Z","timestamp":1790801086095,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health and Welfare through the Korea Health Industry Development Institute","award":["HF20C0012"],"award-info":[{"award-number":["HF20C0012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This pilot study aimed to evaluate the clinical effectiveness, cost-effectiveness, and safety of acupotomy combined with epidural steroid injection (ESI) in lumbosacral radiculopathy and examine its feasibility for the main study. Materials and Methods: This randomized, controlled, two-arm, parallel, assessor-blinded, pragmatic study included 50 patients with severe lumbosacral radiculopathy who had insufficient improvement after an ESI. Patients were randomized (1:1 ratio) into a combined treatment (acupotomy + ESI, experimental) and an ESI single treatment (control) group. Both groups underwent a total of two ESIs once every 2 weeks; the experimental group received eight additional acupotomy treatments twice a week for 4 weeks. Types of ESI included interlaminar, transforaminal, and caudal approaches. Drugs used in ESI comprised a 5\u201310 mL mixture of dexamethasone sodium phosphate (2.5 mg), mepivacaine (0.3%), and hyaluronidase (1500 IU). The primary outcome was the difference in changes from baseline in the Oswestry Disability Index (ODI) scores between the groups at weeks 4 and 8. The incremental cost-utility ratio (ICUR) was calculated to evaluate the cost-effectiveness between the groups. Adverse events (AEs) were assessed at all visits. Results: Mean ODI scores for the experimental and control groups were \u22129.44 (95% confidence interval [CI]: \u221212.71, \u22126.17) and \u22122.16 (95% CI: \u22125.01, 0.69) at week 4, and \u22129.04 (95% CI: \u221212.09, \u22125.99) and \u22124.76 (95% CI: \u22127.68, \u22121.84) at week 8, respectively. The difference in ODI score changes was significant between the groups at week 4 (p = 0.0021). The ICUR of the experimental group versus the control group was as economical as 18,267,754 won\/quality-adjusted life years. No serious AEs were observed. Conclusions: These results demonstrate the potential clinical effectiveness and cost-effectiveness of acupotomy combined with ESI for lumbosacral radiculopathy and its feasibility for a full-scale study. Larger, long-term follow-up clinical trials are needed to confirm these findings.<\/jats:p>","DOI":"10.3390\/medicina60010175","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T03:33:41Z","timestamp":1705635221000},"page":"175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness of Acupotomy Combined with Epidural Steroid Injection for Lumbosacral Radiculopathy: A Randomized Controlled Pragmatic Pilot Study"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8387-2485","authenticated-orcid":false,"given":"Jin-Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Institute for Integrative Medicine, International St. Mary\u2019s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0406-7814","authenticated-orcid":false,"given":"Sang-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Korean Medicine, Graduate School, Pusan National University, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae Sun","family":"Suh","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Kyung Hee University, Seoul 02453, Republic of Korea"},{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul 02453, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man-Suk","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan 50612, Republic of Korea"},{"name":"Third Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semin","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea"},{"name":"Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul 02453, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-8816","authenticated-orcid":false,"given":"Sooil","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, International St. Mary\u2019s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Soo","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, International St. Mary\u2019s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hyun","family":"Byun","sequence":"additional","affiliation":[{"name":"SAGAJEONG Pain and Korean Medicine Clinic, Seoul 02238, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2695-9589","authenticated-orcid":false,"given":"Sang-Hoon","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8798-7578","authenticated-orcid":false,"given":"Sukhee","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, International St. Mary\u2019s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6803-5483","authenticated-orcid":false,"given":"Tae-Yong","family":"Park","sequence":"additional","affiliation":[{"name":"Institute for Integrative Medicine, International St. Mary\u2019s Hospital, Catholic Kwandong University, Incheon 22711, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/j.1533-2500.2010.00370.x","article-title":"Lumbosacral 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