Acupotomy alleviates perineural fibrosis, adhesion, and inflammation in experimental sciatic and vagus nerve adhesion...

Perineural adhesions resulting from surgery, trauma, or chronic inflammation can impair nerve mobility, promote fibrosis, and contribute to neuropathic pain and autonomic dysfunction. Effective minimally invasive therapeutic strategies for established neural adhesions remain limited. This study aimed to establish reproducible rat models of nerve adhesion and neuropathic pain and to evaluate the therapeutic efficacy of acupotomy in alleviating adhesion-related pathological and inflammatory changes. Sciatic nerve chronic constriction injury (S-CCI) and vagus nerve adhesion (V-CCI) models were established in rats. Acupotomy treatment was applied to designated groups following adhesion formation. In the S-CCI model, mechanical allodynia was evaluated using the von Frey filament test. Histological analyses, including Masson's trichrome staining, were performed to assess collagen deposition, inflammation, and adhesion severity. In the V-CCI model, systemic inflammation was assessed by measuring plasma levels of pro-inflammatory cytokines (TNF-α, IL-6, and IL-1β), along with similar histological evaluations. Acupotomy significantly attenuated mechanical allodynia in S-CCI animals, as evidenced by recovery of paw withdrawal threshold ratios following chronic sciatic nerve constriction. Histological analyses demonstrated reduced collagen deposition, fibrosis, inflammatory cell infiltration, and adhesion severity in both S-CCI and V-CCI models following acupotomy treatment. In the V-CCI model, acupotomy significantly decreased circulating IL-1β, IL-6, and TNF-α levels compared with untreated animals, suggesting attenuation of systemic inflammatory responses. Acupotomy effectively alleviated perineural fibrosis, inflammatory changes, and neuropathic pain-related mechanical allodynia while modulating systemic inflammation in experimental neural adhesion models. These findings support acupotomy as a promising minimally invasive therapeutic strategy for the management of adhesion-related neural disorders.