| Summary: | Ruisi Chen,1,2 Jixin Chen,3 Dongdong Cao,1,2 Chao Du,1,2 Jiwei Zhong,1,2 Aifeng Liu1,2 1Department. of Orthopedics and Traumatology, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, People’s Republic of China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People’s Republic of China; 3Department. of Orthopedics and Traumatology, ShaoxingHospital of Traditional Chinese Medicine, Shaoxing, Zhejiang, 312000, People’s Republic of ChinaCorrespondence: Aifeng Liu, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88 Changling Road, Xiqing District, Tianjin, 300381, People’s Republic of China, Tel +86-13803091533, Email draifeng@163.comBackground: Acupuncture has been extensively applied in the clinical management of cervical spondylotic radiculopathy (CSR). This overview aims to systematically summarize the efficacy and safety of acupuncture for the treatment of CSR, as well as to assess the methodological rigor and quality of evidence of the included studies.Methods: A comprehensive literature search for systematic reviews and meta-analyses was conducted across four Chinese and five international databases (PubMed, Web of Science, Cochrane Library, MEDLINE, Embase, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Biomedical Literature Database, and Chongqing VIP).The literature search was conducted from the inception of each database to May 2025 (1996– 2025). The PRISMA 2020 statement, AMSTAR 2, ROBIS, and GRADE tools were used to assess reporting quality, methodological quality, risk of bias, and evidence strength. Qualitative and quantitative evaluations were also performed on the results.Results: Six SR/MA studies were included. One study had relatively complete reporting with a PRISMA score of 24.5, while five showed reporting deficiencies (scores 18– 20). All six studies scored very low on methodological quality according to AMSTAR 2. Only one study was rated as low risk of bias by ROBIS, while five were high risk. GRADE assessment of 41 outcomes showed 2.4% moderate quality, 24.3% low quality, and 73.2% very low quality, mainly downgraded due to study design limitations and publication bias.Conclusion: Acupuncture combined with conventional treatment may provide therapeutic benefits for CSR patients compared to conventional treatment alone. However, the safety of acupuncture for CSR has not been systematically evaluated, and the overall evidence quality is low, so conclusions should be interpreted cautiously.Keywords: acupuncture, cervical spondylotic radiculopathy, overview, AMSTAR 2, GRADE, systematic review
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