{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T12:45:00Z","timestamp":1769258700987,"version":"3.49.0"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development institute","doi-asserted-by":"crossref","award":["HI20C1753"],"award-info":[{"award-number":["HI20C1753"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Degenerative lumbar spinal stenosis (DLSS) frequently manifests as lower leg radiating pain (LLRP), requiring selective nerve root block (SNRB). Comprehensive and Integrative Medical Services (CIMS)\u2014a multimodal program consisting of acupuncture, cupping, and manual therapy\u2014have been increasingly incorporated into clinical practice in Korea. However, randomized evidence remains limited. This study evaluated the efficacy and safety of adjunctive CIMS in patients with DLSS presenting neuropathic LLRP requiring SNRB. Materials and Methods: In a single-center, parallel-group, assessor-blinded randomized controlled trial (CRIS KCT0006036), adults with DLSS (LANSS &gt; 7; VAS &gt; 5) were randomized 1:1 to experimental or control groups (n = 77; experimental 38, control 39). All participants received SNRB plus pharmacotherapy (limaprost, pregabalin). The experimental group additionally received CIMS, delivered eight times over 4 weeks. The primary outcome was pain intensity (VAS) at baseline and weeks 4, 8, and 12. Secondary outcomes included SF-36, ODI, and RMDQ at baseline and weeks 4, 8, and 12. Repeated-measures two-factor ANOVA assessed the main effects and time \u00d7 group interaction. Results: Mean VAS (experimental vs. control) was 4.73 \u00b1 1.67 vs. 4.70 \u00b1 1.95 at baseline; 3.74 \u00b1 1.68 vs. 4.66 \u00b1 1.60 at week 4; 3.93 \u00b1 2.03 vs. 4.79 \u00b1 1.55 at week 8; and 3.98 \u00b1 1.98 vs. 4.98 \u00b1 1.68 at week 12. The significant time \u00d7 group interaction was identified (p = 0.040), indicating a greater pain reduction with CIMS. No significant time \u00d7 group interactions were observed across SF-36 domains. Adherence to CIMS modalities was high, and no unexpected adverse events occurred. Conclusions: In DLSS patients receiving SNRB and pharmacotherapy, adjunctive CIMS resulted in greater pain reduction over 12 weeks compared with standard care alone, without introducing new safety concerns. These findings support the clinical utility of CIMS as an effective adjunctive treatment option for DLSS.<\/jats:p>","DOI":"10.3390\/medicina62010225","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:31:46Z","timestamp":1769009506000},"page":"225","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Comprehensive and Integrative Medical Services on Patients with Degenerative Lumbar Spinal Stenosis: A Randomized Controlled Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-9251","authenticated-orcid":false,"given":"Sang Bong","family":"Ko","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, Daegu Catholic University, Daegu Catholic University Hospital, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0398-5514","authenticated-orcid":false,"given":"Sang Gyu","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-0662","authenticated-orcid":false,"given":"Hee Chan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Armed Forces Daegu Hospital, Gyeongsan 425-95, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.4055\/cios19110","article-title":"Results of Decompression Alone in Patients with Lumbar Spinal Stenosis and Degenerative Spondylolisthesis: A Minimum 5-Year Follow-Up","volume":"12","author":"Ha","year":"2020","journal-title":"Clin. 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