BACKGROUND: In children, cerebral palsy (CP) is one of the most common causes of 
irreversible neurological sequelae. Acupotomy, a modernized acupuncture form 
combining the effects of microsurgery and conventional acupuncture, may show 
specific benefits in the treatment of CP, especially with respect to spasticity. 
The aim of this review was to evaluate the efficacy of acupotomy for CP.
METHODS: Eleven databases were comprehensively searched from their inception 
dates to November 27, 2018. Randomized controlled trials (RCTs) or quasi-RCTs 
evaluating acupotomy as a monotherapy or as adjunctive therapy to rehabilitation 
treatment for CP were included. The methodological quality of included studies 
was assessed using the risk of bias tool. The quality of evidence for each main 
outcome was evaluated using the Grading of Recommendations Assessment, 
Development, and Evaluation approach. Meta-analysis was performed, and the 
pooled data were presented as mean difference (MD) with 95% confidence interval 
(CI) for continuous outcomes and as risk ratio (RR) with 95% CI for dichotomous 
outcomes.
RESULTS: Eight studies involving 530 participants were included. In 1 study, 
acupotomy was associated with significantly higher total effective rate (TER) 
compared with Bobath (P < .01). Acupotomy combined with rehabilitation was 
associated with significantly higher TER (RR 1.24, 95% CI 1.01-1.52, I = 77%) 
and gross motor function measure score (MD 12.62, 95% CI 11.75-13.49, I = 54%), 
and significantly lower muscle tone of gastrocnemius measured by the Ashworth 
scale or the modified Ashworth scale (MD -0.97, 95% CI -1.07 to -0.88, I = 0%) 
compared with rehabilitation alone. No studies reported the incidence of adverse 
events. The methodological quality of the included studies and quality of 
evidence for the main finding were generally low.
CONCLUSION: Current evidence shows that acupotomy as a monotherapy or as 
adjunctive therapy to rehabilitation treatment might have benefits in the 
treatment of CP. However, due to the small number of studies included, the lack 
of sample size, poor methodological qualities, and low quality of evidence, the 
findings of this review should be interpreted with caution. Larger and more 
rigorous, high-quality RCTs should be performed on this topic.
PROSPERO REGISTRATION NUMBER: CRD42018105891.