Abstract
Background: Acupotomy is a modern acupuncture technique using a knife-shaped needle for pain treatment, combining traditional and anatomical knowledge. This study evaluates the diversity and safety of acupotomy procedures for lumbar spine disorders to aid in developing safety and reporting guidelines for clinical studies. Methods: A literature search was conducted on 30 October 2023 in PubMed, five Korean databases, and relevant journals with keywords like 'low back pain' and 'acupotomy'. The search included clinical trial articles in English or Korean on lumbar spinal disorders treated by acupotomy. We reviewed 22 clinical studies involving 731 Korean patients published from 2008 to 2023. Data extracted included disease types, diagnosis methods, treatment specifics, needling factors, anesthesia, clinical outcomes, and safety reports. Results: Most studies focused on lumbar herniated discs and stenosis, with acupotomy performed on damaged tissue sites. Treatment frequency varied, and outcomes included pain scales and imaging assessments. Reporting gaps were found in needle size, insertion depth, and anesthesia status. Safety measures were poorly documented, with only six studies addressing safety and two reporting adverse events. Conclusions: There is a critical need for standardized clinical and reporting guidelines for acupotomy, akin to acupuncture's existing guidelines, to enhance research consistency and quality. Future studies should develop guidelines covering target tissues, needle details, techniques, anesthesia, and adverse effects to improve acupotomy safety and effectiveness.