Table 1.

Summary of the included studies in the review.

First author (year)	Number of primary studies	Meta-analysis	Intervention	Comparison	Clinical outcome	Adverse effects	Conclusion
Liu, 2007 [28]	3	Yes	Acupotomy	Acupuncture (3 studies)	*Cure, markedly effective, effective, ineffective	All trials did not mention whether adverse events have occurred	There are some defects in clinical study on the treatment for CR by acupotomy; treatment for CR by acupotomy is safe and efficient treatment for CR, but the bad quality of articles and the deficiency of methodological decline the efficacy and the reliability
Sun, 2009 [29]	8	Yes	Electropuncture Acupuncture Abdominal acupuncture Abdominal acupuncture + CCT Acupuncture + CCT + massage Electropuncture + massage + CCT + TDP	CCT (2 studies) CCT CCT CCT CCT + massage (2 studies) massage + CCT + TDP	*Cure, markedly effective, effective, ineffective *MPQ	One trial reported the adverse reaction, including mild pain and bleeding	Acupuncture treatment is effective for CR and is superior to traction in the aspects of effective rate and pain alleviating. The curative effect of traction treatment could be improved when combining with acupuncture. However, the conclusion was uncertain because the quality of enrolled papers was partly low
Guo, 2012 [30]	9	Yes	Long's manipulation Manipulation Rotation manipulation Manipulation Manipulation Massage Massage Manipulation	CCT + instruments CCT + IFTA CCT CCT (2 studies) Buluofen tablets CCT CCT + Buluofen CCT + acupuncture	*Cure, markedly effective, effective, ineffective	One trial reported the mild adverse reaction	Manipulation or massage treatment on CR is safe, effective and both cure rate and the effective rate are much better than other therapies; but due to the limited number of documents included and the quality being not very high, the conclusion is still uncertain
Hu, 2012 [31]	14	Yes	Acupuncture Electropuncture Acupuncture + CCT Electropuncture + CCT	CCT (3 studies) CCT (3 studies) CCT (4 studies) CCT (4 studies)	*Cure, markedly effective, effective, ineffective	Two trials reported the safety, but no adverse reactions were observed	Acupuncture was safe in the treatment of CR. Acupuncture showed better clinical effect than traction therapy. In addition, acupuncture had better analgesic effect and could reduce recurrence. Therefore, acupuncture is probably superior to traction therapy in the treatment of CR, which is not definite due to relatively low level of evidence
Wang, 2013 [32]	28	Yes	Massage Massage + CCT Massage Massage + CCT Manipulation Manipulation Massage Massage Manipulation Massage + TCM capsule Massage + TCM Decoction Manipulation + VCDI Massage Manipulation + acupuncture Manipulation + CCT + TCMI Manipulation + CCT + EH Manipulation + CCT + IFTA	CCT (7 studies) CCT (5 studies) CCT + acupuncture Acupuncture + CCT CCT + TCM Pills CCT + Buluofen Lornoxicam tablets TCM capsule TCM plaster TCM capsule TCM decoction VCDI Acupuncture Acupuncture (2 studies) CCT + TCMI CCT + EH CCT + IFTA	*Cure, markedly effective, effective, ineffective *MPQ	Three studies reported the adverse reactions. Only one study described that skin allergy reaction occurred in seven patients after the plaster therapy	Single-application of manipulation or massage was superior to traction group and medicine group in effective rate, while no significant differences were noted between the manipulation or massage group and other control groups. In the trials of comparison between union-application of manipulation or massage and other treatments, only manipulation plus acupuncture versus acupuncture group was not significantly different. However, the conclusion is uncertain because the quality of enrolled papers is partly low
Zhang, 2013 [33]	3	Yes	Jingfukang granule Jingfukang granule Jingfukang granule	CCT + Buluofen Meloxicam tablets TCM granule	*Cure, markedly effective, effective, ineffective	No significant adverse effects or allergic reactions were reported	Jingfukang granule was superior to the other therapies. To compare Jingfukang granules with western medicine, there was no significant advantage. So Jingfukang granule was effective in the treatment of CR. However, the evidence is insufficient to determine the effect of Jingfukang granules
Yang, 2013 [34]	30	Yes	Manipulation Massage + acupressure Massage Mobilization Manipulation + acupressure Manipulation + massage	CCT (18 studies) CCT CCT (5 studies) CCT (3 studies) CCT CCT (2 studies)	*Cure, markedly effective, effective, ineffective *VAS *TCSSG	Fourteen trials mentioned whether adverse events have occurred. Only one trial showed that ten patients presented red mark left on the cervical skin and the pain getting worse after massage	Manipulation or massage has advantages in treating CR with respect to short-term therapy, pain relief and the signs/symptoms amelioration compared with cervical traction. Manipulation or massage is of higher security. Nevertheless, the wide variety of therapeutic manipulation or massage techniques, diagnosis, and treatment standards is inconsistent
Zhu, 2015 [35]	3	Yes	Cervical spine manipulation	CCT (3 studies)	*VAS	One out of three trials reported the adverse events and none with a small sample size	There was moderate level evidence to support the immediate effect of cervical manipulation in treating CR. However, the safety of cervical manipulation cannot be taken as an exact conclusion

^*Definition of “cure,” “markedly effective,” “effective,” and “ineffective,” cured: clinical symptoms resolved, the cervical or limb functions restored to normal.

Markedly effective: clinical symptoms significantly alleviated, cervical and limb functions effective.

Effective: clinical symptoms alleviated, but cervical or limb functions remain impaired. Ineffective: clinical symptoms and signs remain unchanged after the treatment.

^*MPQ: McGill pain questionnaire; ^*VAS: visual analogue scale; ^*TCSSG: total clinical symptoms and signs grading.

CR: cervical radiculopathy; CCT: cervical computer traction; TDP: special electromagnetic therapeutic apparatus; IFTA: intermediate-frequency therapy apparatus.

TCM: traditional Chinese medicine; VCDI: vertebral canal drug injection; TCMI: traditional Chinese medicine injection; EH: electromagnetic heating.