A Randomized Trial of Ultrasound-Guided Acupotomy for Ankylosing Spondylitis

Inclusion criteria

• Meeting the 1984 revised New York criteria or the 2009 Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis.
• Aged 18-75 years.
• Bath Ankylosing Spondylitis Disease Activity Index (BASDAl) score ≥4.
• Provision of written informed consent.

Exclusion criteria

• Presence of other autoimmune or inflammatory rheumatic diseases that may affect outcome assessment, including psoriatic arthritis, reactive arthritis, or inflammatory bowel disease-associated spondyloarthritis;
• Complete spinal ankylosis, severe spinal deformity, previous spinal surgery, or spinal trauma affecting the target treatment area;
• Severe cardiovascular or cerebrovascular disease, severe hepatic or renal dysfunction, malignancy, coagulation disorders, or other conditions considered unsuitable for the intervention;
• Pregnancy or breastfeeding;
• Cognitive impairment or communication difficulties that may affect outcome assessment;
• Use of biologic agents, targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs), conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), systemic corticosteroids, or other immunomodulatory therapies within the previous month;
• Previous acupotomy treatment at the target anatomical site within the previous 3 months;
• Known metal allergy or severe fear of acupotomy procedures.