Comparison of Acupuncture and Lumbar Traction for Lumbar Disc Herniation and Subsequent Risk of Lumbar Fusion or Discectomy: A Retrospective Cohort Study
In brief
Acupuncture was linked to 3.2 fewer discectomies per 100 patients than traction
In a matched retrospective study, 2.5% of patients who received acupuncture had a discectomy within five years, compared with 5.7% who received traction; fusion rates were also lower, 4.2% versus 6.2%. The findings show an association, not proof that acupuncture prevents surgery, since disease severity and other treatments could have influenced who underwent surgery.
- Journal
- Journal of pain research (Q1)
- Published
- 26 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Sung Huang Laurent Tsai, Ming-Hao Chen, Haw-Yiing Hsieh, Lin-Sheng Hsu, Jui Hsu, Hung-Chun Lee, et al.
- PMID
- 42819431
- DOI
- 10.2147/JPR.S631034
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (paper of the day, 4 October 2026): Retrospective cohort comparing acupuncture vs traction for lumbar disc herniation
Abstract
BACKGROUND: Lumbar disc herniation (LDH) is commonly treated with conservative therapies, but comparative evidence on acupuncture versus lumbar traction and subsequent surgery is limited. We examined whether acupuncture was associated with lower 5-year risks of discectomy or spinal fusion than traction among adults with LDH. METHODS: We conducted a retrospective cohort study using deidentified electronic health records from the TriNetX US Collaborative Network from January 1, 2000, to December 31, 2023. Adults aged 20 years or older with LDH who received acupuncture or traction after diagnosis were included. We excluded patients with prior lumbar surgery, lumbar or pelvic fracture, vertebral malignancy, lumbar disc infection or treatment crossover. Propensity score matching was performed 1:1 for demographics, lifestyle factors, comorbidities, health care utilization and body mass index. Primary outcomes were 5-year discectomy and spinal fusion. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. RESULTS: After matching, 3045 patients were included in each group and baseline characteristics were balanced. Discectomy occurred in 77 patients receiving acupuncture and 175 receiving traction (2.5% v. 5.7%; hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.35-0.60; absolute risk reduction [ARR] 3.2%; number needed to treat [NNT] 31). Spinal fusion occurred in 128 patients receiving acupuncture and 188 receiving traction (4.2% v. 6.2%; HR 0.73, 95% CI 0.58-0.91; ARR 2.0%; NNT 51). INTERPRETATION: Among adults with LDH, receipt of acupuncture was associated with lower observed 5-year risks of subsequent discectomy and spinal fusion compared with lumbar traction. These associations should be interpreted cautiously because residual confounding, including differences in concomitant treatments and unmeasured disease severity, cannot be excluded. Prospective studies are needed to determine whether acupuncture itself influences subsequent surgical utilization.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.