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Erschienen in: European Spine Journal 7/2019

21.05.2019 | Original Article

Dextrose injections for failed back surgery syndrome: a consecutive case series

verfasst von: İlker Solmaz, Serkan Akpancar, Aydan Örsçelik, Özlem Yener-Karasimav, Deniz Gül

Erschienen in: European Spine Journal | Ausgabe 7/2019

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Abstract

Purpose

Patients with chronic low back pain, who do not respond to conservative treatment methods, generally undergo surgical revision operations, and sometimes an undesirable condition called failed back surgery syndrome (FBSS) may be inevitable. Hereby, dextrose is one of the regenerative methods that has gained popularity in the treatment of many musculoskeletal problems, and we aimed to present and evaluate the outcomes of 5% dextrose for the treatment of FBSS.

Methods

It has been designed as a consecutive case series. A total of 79 patients with FBSS, who had minimum 6 months of symptoms and did not respond to 3 months of conservative methods between May 2014 and March 2016, participated in the study. Prolotherapy injections were applied in posterior and lateral approaches. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were used for the pre- and post-treatment evaluations. Patient satisfaction was assessed with using a 5-point Likert scale by phone contacting.

Results

There was statistically significant difference between repeated VAS and ODI measurements.

Conclusions

These results may be the first step giving a lead to an undiscovered field. This treatment method should be kept in mind for FBSS patients before giving a decision of revision surgery.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.
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Literatur
2.
Zurück zum Zitat Schofferman J, Reynolds J, Herzog R et al (2003) Failed back surgery: etiology and diagnostic evaluation. Spine J 3(5):400–403CrossRefPubMed Schofferman J, Reynolds J, Herzog R et al (2003) Failed back surgery: etiology and diagnostic evaluation. Spine J 3(5):400–403CrossRefPubMed
4.
Zurück zum Zitat Hussain A, Erdek M (2014) Interventional pain management for failed back surgery syndrome. Pain Pract 14:64–78CrossRefPubMed Hussain A, Erdek M (2014) Interventional pain management for failed back surgery syndrome. Pain Pract 14:64–78CrossRefPubMed
5.
Zurück zum Zitat Choi HS, Chi EH, Kim MR et al (2014) Demographic characteristics and medical service use of failed back surgery syndrome patients at an integrated treatment hospital focusing on complementary and alternative medicine: a retrospective review of electronic medical records. Evid Based Complement Altern Med 2014:714389PubMedPubMedCentral Choi HS, Chi EH, Kim MR et al (2014) Demographic characteristics and medical service use of failed back surgery syndrome patients at an integrated treatment hospital focusing on complementary and alternative medicine: a retrospective review of electronic medical records. Evid Based Complement Altern Med 2014:714389PubMedPubMedCentral
6.
Zurück zum Zitat Shapiro C (2014) The failed back surgery syndrome: pitfalls surrounding evaluation and treatment. Phys Med Rehabil Clin N Am 25(2):319–340CrossRefPubMed Shapiro C (2014) The failed back surgery syndrome: pitfalls surrounding evaluation and treatment. Phys Med Rehabil Clin N Am 25(2):319–340CrossRefPubMed
7.
Zurück zum Zitat Hazard RG (2006) Failed back surgery syndrome: surgical and nonsurgical approaches. Clin Orthop Relat Res 443:228–232CrossRefPubMed Hazard RG (2006) Failed back surgery syndrome: surgical and nonsurgical approaches. Clin Orthop Relat Res 443:228–232CrossRefPubMed
8.
Zurück zum Zitat Weir S, Samnaliev M, Kuo TC et al (2017) The rate of persistent post-operative pain (FBSS) in revision lumbar spinal surgery. Spine J 17(3):S10CrossRef Weir S, Samnaliev M, Kuo TC et al (2017) The rate of persistent post-operative pain (FBSS) in revision lumbar spinal surgery. Spine J 17(3):S10CrossRef
10.
Zurück zum Zitat Seven MM, Ersen O, Akpancar S et al (2017) Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthop Traumatol Surg Res 103(3):427–433CrossRefPubMed Seven MM, Ersen O, Akpancar S et al (2017) Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthop Traumatol Surg Res 103(3):427–433CrossRefPubMed
11.
Zurück zum Zitat Ersen O, Koca K, Akpancar S et al (2017) A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis. Turk J Phys Med Rehab 64(1):i–xiCrossRef Ersen O, Koca K, Akpancar S et al (2017) A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis. Turk J Phys Med Rehab 64(1):i–xiCrossRef
12.
Zurück zum Zitat Akpancar S, Seven MM, Tuzun HY et al (2017) Current concepts of prolotherapy in orthopedic surgery. Arch Trauma Res 6(2):e40447 Akpancar S, Seven MM, Tuzun HY et al (2017) Current concepts of prolotherapy in orthopedic surgery. Arch Trauma Res 6(2):e40447
14.
Zurück zum Zitat Reeves KD, Topol GA, Fullerton BD (2008) Evidence-based regenerative injection therapy (prolotherapy) in sports medicine. In: Seidelberg PH, Beutler PL (eds) The sports medicine resource manual. Saunders, Philadelphia, pp 611–619CrossRef Reeves KD, Topol GA, Fullerton BD (2008) Evidence-based regenerative injection therapy (prolotherapy) in sports medicine. In: Seidelberg PH, Beutler PL (eds) The sports medicine resource manual. Saunders, Philadelphia, pp 611–619CrossRef
15.
Zurück zum Zitat Di Paolo S, Gesualdo L, Ranieri E, Grandaliano G, Schena FP (1996) High glucose concentration induces the overexpression of transforming growth factor-beta through the activation of a platelet-derived growth factor loop in human mesangial cells. Am J Pathol. 149(6):2095–2106PubMedPubMedCentral Di Paolo S, Gesualdo L, Ranieri E, Grandaliano G, Schena FP (1996) High glucose concentration induces the overexpression of transforming growth factor-beta through the activation of a platelet-derived growth factor loop in human mesangial cells. Am J Pathol. 149(6):2095–2106PubMedPubMedCentral
16.
Zurück zum Zitat Murphy M, Godson C, Cannon S, Kato S, Mackenzie HS, Martin F et al (1999) Suppression subtractive hybridization identifies high glucose levels as a stimulus for expression of connective tissue growth factor and other genes in human mesangial cells. J Biol Chem. 274(9):5830–5834CrossRefPubMed Murphy M, Godson C, Cannon S, Kato S, Mackenzie HS, Martin F et al (1999) Suppression subtractive hybridization identifies high glucose levels as a stimulus for expression of connective tissue growth factor and other genes in human mesangial cells. J Biol Chem. 274(9):5830–5834CrossRefPubMed
17.
Zurück zum Zitat Krump E, Nikitas K, Grinstein S (1997) Induction of tyrosine phosphorylation and Na+/H+ exchanger activation during shrinkage of human neutrophils. J Biol Chem 272(28):17303–17311CrossRefPubMed Krump E, Nikitas K, Grinstein S (1997) Induction of tyrosine phosphorylation and Na+/H+ exchanger activation during shrinkage of human neutrophils. J Biol Chem 272(28):17303–17311CrossRefPubMed
18.
Zurück zum Zitat Lyftogt J (2008) Pain conundrums: which hypothesis? Central nervous system sensitization versus peripheral nervous system autonomy. Aust Musculoskelet Med 13(2):72 Lyftogt J (2008) Pain conundrums: which hypothesis? Central nervous system sensitization versus peripheral nervous system autonomy. Aust Musculoskelet Med 13(2):72
21.
Zurück zum Zitat Yelland MJ, Glasziou PP, Bogduk N, et al (2004) Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine (Phila Pa 1976) 29(1):9–16 (discussion 16) CrossRef Yelland MJ, Glasziou PP, Bogduk N, et al (2004) Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine (Phila Pa 1976) 29(1):9–16 (discussion 16) CrossRef
22.
Zurück zum Zitat Dagenais S, Yelland MJ, Del Mar C, Schoene ML (2007) Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev. 18(2):CD004059. Dagenais S, Yelland MJ, Del Mar C, Schoene ML (2007) Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev. 18(2):CD004059.
23.
Zurück zum Zitat Guran S, Coban ZD, Karasimav O et al (2018) Dextrose solution used for prolotherapy decreases cell viability and increases gene expressions of angiogenic and apopitotic factors. Gulhane Med J 60:42CrossRef Guran S, Coban ZD, Karasimav O et al (2018) Dextrose solution used for prolotherapy decreases cell viability and increases gene expressions of angiogenic and apopitotic factors. Gulhane Med J 60:42CrossRef
24.
Zurück zum Zitat Hackett GS, Hemwall GA, Montgomery GA (1993) Ligament and tendon relaxation treated by prolotherapy, 5th edn. Gustav A. Hemwall, Oak Park Hackett GS, Hemwall GA, Montgomery GA (1993) Ligament and tendon relaxation treated by prolotherapy, 5th edn. Gustav A. Hemwall, Oak Park
25.
26.
Zurück zum Zitat Jamieson S (2004) Likert scales: how to (ab)use them. Med Educ 38(12):1217–1218 Jamieson S (2004) Likert scales: how to (ab)use them. Med Educ 38(12):1217–1218
27.
Zurück zum Zitat Lee JH, Lee SH (2014) Clinical effectiveness of percutaneous adhesiolysis versus transforaminal epidural steroid injection in patients with postlumbar surgery syndrome. Reg Anesth Pain Med 39:214–218CrossRefPubMed Lee JH, Lee SH (2014) Clinical effectiveness of percutaneous adhesiolysis versus transforaminal epidural steroid injection in patients with postlumbar surgery syndrome. Reg Anesth Pain Med 39:214–218CrossRefPubMed
28.
Zurück zum Zitat Hollingworth W, Turner JA, Welton NJ et al (2011) Costs and cost effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome. Spine 36:2076–2083CrossRefPubMed Hollingworth W, Turner JA, Welton NJ et al (2011) Costs and cost effectiveness of spinal cord stimulation (SCS) for failed back surgery syndrome. Spine 36:2076–2083CrossRefPubMed
29.
Zurück zum Zitat Lad SP, Babu R, Bagley JH et al (2014) Utilization of spinal cord stimulation in patients with failed back surgery syndrome. Spine 39:E719–E727CrossRefPubMed Lad SP, Babu R, Bagley JH et al (2014) Utilization of spinal cord stimulation in patients with failed back surgery syndrome. Spine 39:E719–E727CrossRefPubMed
30.
Zurück zum Zitat North RB, Kidd D, Shipley J et al (2007) Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial. Neurosurgery 61:361–368CrossRefPubMed North RB, Kidd D, Shipley J et al (2007) Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial. Neurosurgery 61:361–368CrossRefPubMed
31.
Zurück zum Zitat Manchikanti L, Abdi S, Atluri S et al (2013) An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician 16:S49–283PubMed Manchikanti L, Abdi S, Atluri S et al (2013) An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician 16:S49–283PubMed
32.
Zurück zum Zitat Chun-jing J, Hao-xiong N, Jia-ziang N (2012) The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome. Acta Cir Bras 27:357–362CrossRefPubMed Chun-jing J, Hao-xiong N, Jia-ziang N (2012) The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome. Acta Cir Bras 27:357–362CrossRefPubMed
33.
Zurück zum Zitat Manchikanti L, Boswell MV, Datta S et al (2009) Comprehensive review of therapeutic interventions in managing chronic spinal pain. Pain Physician 12:E123–E198PubMed Manchikanti L, Boswell MV, Datta S et al (2009) Comprehensive review of therapeutic interventions in managing chronic spinal pain. Pain Physician 12:E123–E198PubMed
34.
Zurück zum Zitat Fritsch EW, Heisel J, Rupp S (1996) The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine (Phila Pa 1976) 21: 626–633CrossRef Fritsch EW, Heisel J, Rupp S (1996) The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine (Phila Pa 1976) 21: 626–633CrossRef
35.
Zurück zum Zitat Amirdelfan K, Webster L, Poree L et al (2017) Treatment options for failed back surgery syndrome patients with refractory chronic pain: an evidence based approach. Spine 42:S41–S52CrossRefPubMed Amirdelfan K, Webster L, Poree L et al (2017) Treatment options for failed back surgery syndrome patients with refractory chronic pain: an evidence based approach. Spine 42:S41–S52CrossRefPubMed
36.
Zurück zum Zitat Louw A, Diener I, Landers MR et al (2014) Preoperative pain neuroscience education for lumbar radiculopathy: a multicenter randomized controlled trial with 1-year follow-up. Spine (Phila Pa 1976) 39:1449–1457CrossRef Louw A, Diener I, Landers MR et al (2014) Preoperative pain neuroscience education for lumbar radiculopathy: a multicenter randomized controlled trial with 1-year follow-up. Spine (Phila Pa 1976) 39:1449–1457CrossRef
37.
Zurück zum Zitat Brox JI, Reikeras O, Nygaard O et al (2006) Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study. Pain 122:145–155CrossRefPubMed Brox JI, Reikeras O, Nygaard O et al (2006) Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study. Pain 122:145–155CrossRefPubMed
39.
Zurück zum Zitat Thomson S, Jacques L (2009) Demographic characteristics of patients with severe neuropathic pain secondary to failed back surgery syndrome (PROCESS study). Pain Pract 9:206–214CrossRefPubMed Thomson S, Jacques L (2009) Demographic characteristics of patients with severe neuropathic pain secondary to failed back surgery syndrome (PROCESS study). Pain Pract 9:206–214CrossRefPubMed
40.
Zurück zum Zitat Drucker M, Cardenas E, Arizti P et al (1998) Experimental studies on the effect of lidocaine on wound healing. World J Surg. 22(4):394–397 (discussion 397–8) CrossRefPubMed Drucker M, Cardenas E, Arizti P et al (1998) Experimental studies on the effect of lidocaine on wound healing. World J Surg. 22(4):394–397 (discussion 397–8) CrossRefPubMed
41.
Zurück zum Zitat Kim MY, Na YM, Moon JH (1997) Comparison on treatment effects of dextrose water, saline, and lidocaine for trigger point injection. J Korean Acad Rehabil Med 21(5):967–973 Kim MY, Na YM, Moon JH (1997) Comparison on treatment effects of dextrose water, saline, and lidocaine for trigger point injection. J Korean Acad Rehabil Med 21(5):967–973
42.
Zurück zum Zitat Rabago D, Kijowski R, Woods M et al (2013) Association between disease-specific quality of life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis. Arch Phys Med Rehabil 94(11):2075–2082CrossRefPubMed Rabago D, Kijowski R, Woods M et al (2013) Association between disease-specific quality of life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis. Arch Phys Med Rehabil 94(11):2075–2082CrossRefPubMed
43.
Zurück zum Zitat Panjabi M, Abumi K, Duranceau J et al (1989) Spinal stability and intersegmental muscle forces. A biomechanical model. Spine 14(2):194–200PubMed Panjabi M, Abumi K, Duranceau J et al (1989) Spinal stability and intersegmental muscle forces. A biomechanical model. Spine 14(2):194–200PubMed
44.
Zurück zum Zitat Clemente CD (1985) Gray’s Anatomy, 30th edn. Lea & Febiger, Philadelphia Clemente CD (1985) Gray’s Anatomy, 30th edn. Lea & Febiger, Philadelphia
45.
Zurück zum Zitat Yelland M, Glasziou P, Bogduk N, Schluter P, McKernon M (2004) Prolotherapy injections, saline injections, and exercises for chronic low back pain: a randomized trial. Spine 29(1):9–16CrossRefPubMed Yelland M, Glasziou P, Bogduk N, Schluter P, McKernon M (2004) Prolotherapy injections, saline injections, and exercises for chronic low back pain: a randomized trial. Spine 29(1):9–16CrossRefPubMed
Metadaten
Titel
Dextrose injections for failed back surgery syndrome: a consecutive case series
verfasst von
İlker Solmaz
Serkan Akpancar
Aydan Örsçelik
Özlem Yener-Karasimav
Deniz Gül
Publikationsdatum
21.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 7/2019
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-019-06011-3

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