CASE REPORT article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicAdvancing Orthopedic Surgery: unique Case Reports driving progressView all 5 articles
Case Report: Long-term Improvement after Acupotomy in Advanced Ankylosing Spondylitis with Sacroiliac Joint Fusion
Provisionally accepted
- 1Luohu Clinical Institute, Shantou University Medical College, Shantou 515000, China, Shenzhen, China
- 2Famous Traditional Chinese Medicine Clinic, Shenzhen Hospital of Shanghai University of Traditional Chinese Medicine, Guangdong, China., Shenzhen, China
- 3Respiratory and Critical Care Department, Shenzhen Hospital of Shanghai University of Traditional Chinese Medicine, Guangdong, China., Shenzhen, China
- 4Department of Radiology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China, Shenzhen, China
- 5Medical Laboratory, Shenzhen Luohu People's Hospital, Shenzhen, Guangdong, 518000, China., Shenzhen, China
- 6Traditional Chinese Medicine (TCM) Diagnosis and Treatment Center, Changsha Fourth Hospital (Changsha Hospital of Integrated Traditional Chinese and Western Medicine)., Changsha, China
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Background: Evidence for acupotomy in managing advanced ankylosing spondylitis (AS) with extensive bony fusion, particularly in treatment-refractory cases, remains limited. This report details its application and outcomes in one such patient. Case Presentation: A 27-year-old male with advanced, active AS and bilateral sacroiliac joint fusion presented with severe low back pain, kyphosis, and markedly restricted mobility. His condition was refractory to prior conservative therapies, including NSAIDs and traditional acupuncture. He subsequently underwent five sessions of anatomy-guided acupotomy, targeting fascial adhesions in the thoracolumbar fascia, sacroiliac ligaments, and lumbar facet joints. Results: The intervention yielded substantial and sustained improvements. Pain intensity (VAS) decreased from 7 to 2, while disease activity (BASDAI) and functional impairment (BASFI) scores reduced from 3.7 to 1.3 and 4.0 to 1.0, respectively. Spinal range of motion and postural alignment were largely restored. These functional benefits proved durable over a 2-year follow-up, during which follow-up imaging confirmed persistent structural fusion, underscoring that clinical improvement was attributable to restored soft-tissue function rather than structural reversal. Conclusion: Acupotomy induced significant, long-term clinical improvement in this refractory AS case, likely through mechanical release of fascial restrictions. It represents a promising complementary, symptom-and function-modifying intervention for patients with limited response to conventional regimens.
Keywords: ultrasound, Thoracolumbar fascia, Posture correction, minimally invasive surgery, Dynamic release, Trigger Points
Received: 17 Oct 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Yu, Zixi, Yangguang, Xiangrui, Dongyue, Liyong and Qiuxia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ding Qiuxia
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