A Randomized Trial of Ultrasound-Guided Acupotomy for Ankylosing Spondylitis

Inclusion Criteria: 1. Meeting the 1984 revised New York criteria or the 2009 Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis. 2. Aged 18-75 years. 3. Bath Ankylosing Spondylitis Disease Activity Index (BASDAl) score ≥4. 4. Provision of written informed consent. Exclusion Criteria: 1. Presence of other autoimmune or inflammatory rheumatic diseases that may affect outcome assessment, including psoriatic arthritis, reactive arthritis, or inflammatory bowel disease-associated spondyloarthritis; 2. Complete spinal ankylosis, severe spinal deformity, previous spinal surgery, or spinal trauma affecting the target treatment area; 3. Severe cardiovascular or cerebrovascular disease, severe hepatic or renal dysfunction, malignancy, coagulation disorders, or other conditions considered unsuitable for the intervention; 4. Pregnancy or breastfeeding; 5. Cognitive impairment or communication difficulties that may affect outcome assessment; 6. 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; 7. Previous acupotomy treatment at the target anatomical site within the previous 3 months; 8. Known metal allergy or severe fear of acupotomy procedures.