SYSTEMATIC REVIEW article
Front. Med.
Sec. Rheumatology
This article is part of the Research TopicTherapeutic Strategies: Rehabilitation, Complementary and Alternative Therapies for Musculoskeletal DiseasesView all 6 articles
Effectiveness and Safety of Ultrasound-Guided Needle-Knife Therapy for Patients with Spinal Pain Disorders: A Systematic Review and Meta-analysis
Provisionally accepted
Do-Young Kim1,2
Joon-Seok Lee3
Sook Hyun Lee4
Yoon Jae Lee4
Juyeon Kim4In Heo5Jae-Heung Cho6
Byung-Kwan Seo6
In-Huyk Ha4*- 1Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
- 2Seoul National University, Gwanak-gu, Republic of Korea
- 3Jaseng Hospital of Korean Medicine, Gangnam-gu, Republic of Korea
- 4Jaseng Medical Foundation, Gangnam-gu, Republic of Korea
- 5Pusan National University, Geumjeong-gu, Republic of Korea
- 6Kyung Hee University, Dongdaemun-gu, Republic of Korea
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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. Method: 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%).
Keywords: ultrasound-guided needle-knife therapy, spinal pain disorders, minimally invasive treatment, Pain Reduction, physical function improvement, systematic review and meta-analysis, adverse events
Received: 15 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Kim, Lee, Lee, Lee, Kim, Heo, Cho, Seo and Ha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: In-Huyk Ha, hanihata@gmail.com
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