Intraspinal versus Extraspinal Acupotomy Decompression, or Their Combination, for Lumbar Disc Herniation: Protocol for a Three-Arm, Randomized, Single-Blind Controlled Trial.

Researchers are testing a new acupuncture technique for people with lumbar disc herniation, a condition where spinal discs press on nerves causing back and leg pain. Traditional acupotomy (a combination of acupuncture and surgical techniques) has helped with back pain, but hasn't been as effective for the shooting pain down the legs that many patients experience. Scientists have developed a new approach called "intraspinal acupotomy decompression" that targets special ligaments deep in the spine to relieve pressure on compressed nerves. This study will compare three different treatment approaches in 210 patients aged 20-85: the traditional extraspinal technique, the new intraspinal technique, and a combination of both. Participants will receive one treatment weekly for four weeks, then be followed for another four weeks. Researchers will measure pain levels, back function, and quality of life to determine which approach works best. Since this is a protocol paper describing the planned study rather than reporting results, no findings are available yet. However, if successful, this research could offer patients with disc herniation a more effective minimally invasive treatment option, especially for those suffering from nerve-related leg pain that hasn't responded well to current treatments. If you're considering acupotomy for disc herniation, seek a qualified practitioner trained in these specialized techniques.

This protocol describes a three-arm, single-blind randomized controlled trial comparing extraspinal acupotomy, intraspinal acupotomy decompression, and combined approaches for lumbar disc herniation. The study will enroll 210 patients (n=70 per group) aged 20-85 years receiving weekly treatments for four weeks. Intraspinal acupotomy targets meningovertebral ligaments to address neural compression, potentially overcoming traditional acupotomy's limitations in treating radicular symptoms. Primary outcomes include VAS pain scores and JOA lumbar function scores assessed at baseline, 4 weeks, and 8 weeks (primary endpoint). Secondary outcomes measure quality of life (SF-36) and adverse events. This is a protocol publication; no efficacy data are yet available. The assessor-blinded design maintains outcome measurement integrity despite the impossibility of blinding practitioners and participants to the intervention type. Results will provide comparative efficacy data for optimizing acupotomy decompression strategies in LDH management, particularly for patients with refractory radicular symptoms.