Efficacy of Fu’s subcutaneous needling in the treatment of neck-type cervical spondylosis: A systematic review and meta-analysis

Background: As a minimally invasive technique, Fu’s subcutaneous needling (FSN) has been widely adopted in Chinese clinical practice for managing neck-type cervical spondylosis (CS). However, current evidence regarding its therapeutic efficacy remains inconclusive due to methodological limitations in existing studies. This systematic review and meta-analysis therefore sought to quantitatively synthesize available randomized controlled trials to evaluate the clinical effectiveness and safety of FSN for this prevalent musculoskeletal disorder. Methods: This study protocol was prospectively registered in PROSPERO (Registration ID: CRD420251036627). The databases searched include PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform (Wanfang), VIP Database (VIP), and China Biology Medicine disc (CBM). A comprehensive search was conducted across the 8 electronic databases from their inception through April 18, 2025. Eligible studies included randomized controlled trials comparing FSN with non-FSN therapies for neck-type CS. Results: This study included 10 clinical studies with a total of 696 patients suffering from neck-type CS. The results of the meta - analysis revealed that the experimental group had significant advantages over the control group in terms of clinical efficacy. Specifically, for the total effective rate (odds ratio = 5.45, 95% confidence intervals [CI] = [2.75, 10.81], Z = 4.85, P < .00001), cure rate (odds ratio = 2.25, 95% CI = [1.51, 3.34], Z = 4.01, P < .00001), visual analogue scale score (VAS, mean difference = −1.21, 95% CI = [−1.30, −1.12], Z = 25.10, P < .00001), and Neck Disability Index score (NDI, mean difference = −1.33, 95% CI = [−1.92, −0.75], Z = 4.48, P < .00001), the experimental group outperformed the control group. Conclusion: This study indicates that FSN is a safe and effective strategy for managing neck-type CS. Therefore, it can be considered as a common clinical treatment modality for neck-type CS.