Case Report: Long-term improvement after acupotomy in advanced ankylosing spondylitis with sacroiliac joint fusion.

Researchers report significant long-term improvements in a patient with advanced ankylosing spondylitis (AS) using acupotomy, a specialized technique involving needle-knife instruments. The patient was a 27-year-old man with severe AS who had complete fusion of his sacroiliac joints and wasn't responding to standard treatments like anti-inflammatory medications and regular acupuncture. He experienced debilitating low back pain, a hunched posture, and severely limited movement. After five sessions of acupotomy targeting tight connective tissue around his spine and lower back, the patient experienced remarkable improvements. His pain level dropped from 7 out of 10 to just 2, while his ability to perform daily activities improved dramatically. His disease activity score decreased from 3.7 to 1.3, and his functional impairment score fell from 4.0 to 1.0. Most notably, his spinal mobility and posture were largely restored. These improvements lasted for at least two years after treatment. Follow-up imaging showed that the bony fusion remained unchanged, meaning the benefits came from releasing tight soft tissues rather than reversing the structural damage. This case suggests acupotomy may offer hope for AS patients who haven't responded well to conventional treatments, working by mechanically releasing fascial restrictions that limit movement and cause pain. While this is just one case and more research is needed, it demonstrates acupotomy's potential as a complementary therapy for advanced AS. Patients interested in this approach should seek a qualified practitioner specifically trained in acupotomy techniques.

This case report documents sustained clinical improvement following acupotomy in treatment-refractory advanced AS with bilateral sacroiliac fusion. A 27-year-old male underwent five anatomy-guided acupotomy sessions targeting fascial adhesions in thoracolumbar fascia, sacroiliac ligaments, and lumbar facet joints. Outcomes demonstrated substantial reductions: VAS decreased from 7 to 2, BASDAI from 3.7 to 1.3, and BASFI from 4.0 to 1.0. Significant improvements in spinal range of motion and postural alignment were achieved and maintained over 24-month follow-up. Importantly, follow-up imaging confirmed persistent structural fusion, indicating clinical benefits derived from soft-tissue mechanical release rather than structural modification. This single-case study (n=1) suggests acupotomy may serve as an effective symptom- and function-modifying intervention for advanced AS refractory to NSAIDs and conventional acupuncture. The technique's mechanism appears to involve fascial adhesion release. While promising, larger controlled studies are needed to establish efficacy and safety profiles for broader clinical application.