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J Acupunct Res > Volume 32(4); 2015 > Article
Bae, Kim, Kim, Lee, Yang, and Kim: Korean Medicine for Thoracolumbar Compression Fracture in Korean Literature: a Systematic Review※
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This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture


We searched six Korean databases (DBPIA Korean Studies Information Service System Oriental Medicine Advanced Searching Integrated System National Digital Science Library Research Information Sharing Service KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society Unpublished studies were also searched Clinical research other than case reports involving less than 10 patients were eligible The effectiveness and safety of Korean Medicine was analyzed The ‘Risk of Bias’ was assessed using the ‘Risk of Bias’ assessment tool for non-randomized studies as well as the Cochrane Collaboration’s ‘Risk of Bias’ tool


We found 12 before-after studies (374 patients) There was no randomized trial All studies combined at least three different types of Korean medicine treatments The period of treatment varied between less a week and 154 days All the included studies reported improvements in pain functional disability related to lower back pain global assessment and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline However all studies had a high risk of bias and three studies reported mild adverse events


There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture The effectiveness and safety of Korean medicine for this population remains unclear Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies Future high-quality randomized trials are warranted

Fig. 1
Flowchart of Study Selection Process
KISS*: Korean Studies Information Service System
RISS: Research Information Sharing Service
OASIS: Oriental Medicine Advanced Searching Integrated System
NDSL§: National Digital Science Library
One Journal: The Journal of Korean Acupuncture & Moxibustion Society
Fig. 2
Summary of Risk of Bias
Table 1
Characteristics of Included Studies
Author (year) Number of patient Intervention Outcome
Acupuncture Herb Cupping Moxibustion Medication Others Measurement Adverse events
Jung (2009)33) 48 · · PT*, BR Global Assessment NR
Joh (2009)29) 16 Brace, BR 1. Primary outcome: Compression Ratio
2. Secondary outcome: Visual Analogue Scale
Jin (2008)24) 35 · · · PT Numerical Rating Scale No occurrence
Yang (2008)32) 28 · PT, BR Visual Analogue Scale Oswestry Disability Index NR
Lee (2002)30) 39 · PT, BR Global Assessment No occurrence
Song (2001)31) 50 · · PT, BR Brace Global Assessment NR
Oh (2001)28) 40 · · PT, BR Global Assessment NR
Han (2001)34) 31 · PT, Brace, Chuna Global Assessment, Compression Ratio Reported
Lim (2000)29) 44 · PT, BR Global Assessment NR
Lee (1998)27) 32 · · PT, BR Global Assessment NR
Lee (1997)23) 40 · · PT, Brace DITI§ Global Assessment NR
Lee (1993)25) 20 · · · PT, Brace Global Assessment NR

PT*: physical therapy, This includes hot pack, exercise, transcutaneous electrical nerve stimulation (TENS), interferential current therapy (OCT), ultra sound (US) and infra red (IR).

BR: bed rest.

NR: not reported.

DITI§: digital infrared thermal imaging.

Reported: This includes constipation (n=19), indigestion/anorexia (n=16), upper respiratory infection (n=9), leg pain/paresthesia/weakness (n=7), urination disorder (n=7), headache/dizziness (n=6), general weakness (n=5), chest discomfort (n=5), sleep disorder (n=4), urinary tract infection (n=2).



1. Society KSN. The Textbook of Spine. ver 2.0. 2013:523–48.

2. Denis F. The three column spine and its significanceinthe classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983;8(8):817–31.
crossref pmid
3. Melton LJ 3rd, Thamer M, Ray NF, et al. Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997;12(1):16–23.
crossref pmid
4. Genant HK, Cooper C, Poor G, et al. Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int. 1999;10(4):259–64.
crossref pmid
5. Oudshoorn C, Hartholt KA, Zillikens MC, et al. Emergency department visits due to vertebral fractures in the Netherlands, 1986–2008: steep increase in the oldest old, strong association with falls. Injury. 2012;43(4):458–61.
crossref pmid
6. Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ 3rd. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res. 1992;7(2):221–7.
crossref pmid
7. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–33.
crossref pmid
8. David S, Kuhn C, Ekkernkamp A. Fracture of the proximal humerus in children and adolescents. The most overtreated fracture. Chirurg. 2006;77(9):827–34.
crossref pmid
9. Silverman SL. The clinical consequences of vertebral compression fracture. Bone. 1992;13(Suppl 2):S27–31.
crossref pmid
10. Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O, European Vertebral Osteoporosis S. Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int. 2003;14(1):61–8.
crossref pmid
11. Hasserius R, Karlsson MK, Jonsson B, Redlund-Johnell I, Johnell O. Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly–a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int. 2005;76(4):235–42.
crossref pmid
12. Agulnek AN, O’Leary KJ, Edwards BJ. Acute vertebral fracture. J Hosp Med. 2009;4(7):E20–4.
13. Lee JY, Vaccaro AR, Lim MR, et al. Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma. J Orthop Sci. 2005;10(6):671–5.
crossref pmid pmc
14. Association TKO. Orthopeadics. 6th ed. Seoul: Choishin Medical. 2006:957–88.

15. Savage JW, Schroeder GD, Anderson PA. Vertebroplasty and Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures. J Am Acad Orthop Surg. 2014;22(10):653–64.
crossref pmid
16. Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am. 1998;36(3):533–46.
crossref pmid
17. Buchbinder R, Golmohammadi K, Johnston RV, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2015;4:CD006349.
18. Abudou M, Chen X, Kong X, Wu T. Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit. Cochrane Database Syst Rev. 2013;6:CD005079.
19. JI SY. Bibliographic study on method of treating the diseases inside the body applied to fracture. The Journal of Korean Medicine Ophthalmology, Otolaryngology & Dermatology. 1995;8(1):113–29.

20. Higgins JPT GS. Cochrane handbook for systematic reviews of interventions. version 5.0.2. The Cochrane Collaboration. 2009:187–241.

21. Kim SY, Park JE, Lee YJ, et al. Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J Clin Epidemiol. 2013;66(4):408–14.
crossref pmid
22. Higgins J GS. Analysing and presenting results. Cochrane handbook for systematic reviews of interventions 4.2.6. Chichester, UK: John Wiley & Sons Inc. 2008:79–165.

23. Lee GM, Moon SJ, Lee BC. Clinical evaluation of Oriental Medicine treatment of Stable Compression Fracture by D.I.T.I. The Acupuncture. 1997;1(1):28–37.

24. Jin ES, Koh DH, Kim HN. The Clinical Study of 35 Admission Patients to Oriental Medical Hospital due to Thoraco-Lumbar Compression Fracture. Korean Society of Chuna manual Medicine for Spine and Nerves. 2008;3(2):19–27.

25. Lee GM, Seong NG, Chae WS. Clinical Study of Stable Thoracolumbar Vertebral Fractures. The Acupuncture. 1993;10(1):339–52.

26. Joh BJ, Koh PS, Yi WI, Baek YH, Nam TH, Park DS. Clinical study on 16 conservatively treated acute compression fracture patients with focus on compression ratio. The Acupuncture. 2009;26(4):1–9.

27. Lee JG, Lee BR. The clinical study on 32 cases of patient with Thoracolumbar Compression Fracture. The Acupuncture. 1998;15(2):427–36.

28. Oh H, Kim ID, Byun JY, Ahn SG. The Clinical Study on 40 cases of Patient with Thoracolumbar Fracture. The Acupuncture. 2001;18(2):227–36.

29. Lim JE, Kim KH, Hwang HS. The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture. The Acupuncture. 2000;17(2):41–51.

30. Lee SN, Hong SY, Byun IJ. The Clinical Study on Bee Venom Acupuncture Treatment of Patient with Thoracolumbar Compression Fracture. The Acupuncture. 2002;19(6):35–48.

31. Song WS, Hwang JY, Shin YI, Lee BR. The Clinical Study on Hua-Tua-Jia-Ji-Xue Acupuncture Treatment of Patient with Thoracolumbar Compression Fracture. The Acupuncture. 2001;18(4):55–67.

32. Yang GR, Sohn HS. Effect of Bee Venom Acupuncture complex Therapy of Thoracolumbar Compressiono Fracture. The Acupuncture. 2008;25(3):29–39.

33. Jung KH, Cha JH, Hwang HS. Effect of Oriental Medicine Treatment on Inpatient with Thoracolumbar Compression Fracture. The Acupuncture. 2009;26(1):81–90.

34. Han JS, Heo DS, Keum DH. Prognostic Factors of Stable Thoracolumbar Spine Fracture. JORM. 2001;11(4):49–58.

35. Kim SY, Choi MY, Shin SS, et al. Handbook for Clinical Practice Guideline Developer: Version 1.0. NECA. 2015;383–8.

36. Holdsworth F. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am. 1970;52(8):1534–51.
crossref pmid
37. Hrobjartsson A, Thomsen AS, Emanuelsson F, et al. Observer biasin randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors. Bmj. 2012;344:e1119.
crossref pmid
38. White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004;22(3):122–33.
crossref pmid
39. Park JY, Kim SY, Chae YB, et al. Systematic Review of Adverse Events Related to Acupuncture and Moxivbustion in Korea. J Korean Oriental Med. 2010;31(2):78–90.

40. Chang V, Holly LT. Bracing for thoracolumbar fractures. Neurosurg Focus. 2014;37(1):E3.
41. Savage JW, Schroeder GD, Anderson PA. Vertebroplasty and Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures. Journal of the American Academy of Orthopaedic Surgeons. 2014;22(10):653–4.
crossref pmid
42. Koester MC, Spindler KP. Pharmacologic agents in fracture healing. Clin Sports Med. 2006;25(1):63–73, viii.
crossref pmid
43. Lee HJ, Seo JC, Park SH, et al. Acupuncture in patients with a vertebral compression fracture: a protocol for a randomized, controlled, pilot clinical trial. J Pharmacopuncture. 2015;18(1):79–85.
crossref pmid pmc
44. Han JS, Terenius L. Neurochemical basis of acupuncture analgesia. Annu Rev Pharmacol Toxicol. 1982;22:193–220.
crossref pmid
45. Mak JC. Acupuncture in osteoporosis: more evidence is needed. Acupunct Med. 2015;33(6):440–1.
crossref pmid
46. He J, Yang L, Qing Y, He C. Effects of electroacupuncture on bone mineral density, oestradiol level and osteoprotegerin ligand expression in ovariectomised rabbits. Acupunct Med. 2014;32(1):37–42.
crossref pmid
47. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R. Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complement Ther Med. 2001;9(4):246–9.
crossref pmid
48. McGuire R. AAOS Clinical Practice Guideline: the Treatment of Symptomatic Osteoporotic Spinal Compression Fractures. J Am Acad Orthop Surg. 2011;19(3):183–4.
crossref pmid
49. Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8:18.
crossref pmid pmc

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