Prolotherapy at Multifidus Muscle versus Mechanical Needling and Sterile Water Injection in Lumbar Spinal Stenosis

Abstract

Objective

This observational study aimed to compare ultrasound-guided (USG) prolotherapy with 5% dextrose in water (D5W) in the multifidus muscle to USG mechanical needling and sterile water injections for the treatment of lumbar spinal stenosis (LSS).

Patients and Methods

The data was extracted from the medical records of ageing patients with LSS who received USG D5W in the multifidus muscle or USG mechanical needling and sterile water injections for the treatment of LSS by the first author. Low back pain or axial pain and leg pain or radicular pain were assessed by the visual analogue scale, and gait ability with walking distance were obtained at six different time points.

Results

Among the 211 older people who were diagnosed with LSS, 104 got USG mechanical needling and sterile water injections over the course of four weeks, while the other 107 got D5W at the multifidus muscles in a single session. Chronic low back pain, radiating pain, and the ability to walk all got much better at 1 and 3 months after the intervention, compared to VAS measures taken at the start. Patients who underwent mechanical needling with injections of sterile water performed consistently and significantly better than those who received prolotherapy in the multifidus muscles on all measures at 1, 3, and 6 months.

Conclusion

After receiving USG mechanical needling and sterile water, LSS patients reported significant improvements in low back pain, radicular pain, and ability to walk for at least 6 months. Prolotherapy with D5W in the multifidus muscle has a moderate effect for only three months.

Keywords:

• mechanical needling plus sterile water injection
• prolotherapy with D5W
• multifidus muscle
• ultrasound-guided
• USG
• lumbar spinal stenosis
• LSS

Ethical Approval

This study was performed in accordance with the principles of the Declaration of Helsinki, including patient data confidentiality. The Institutional Review Board of Chang Gung Medical Foundation approved this study (IRB number 202200443A3). Since this was an observational retrospective study, written informed consent was waived.

Acknowledgments

The authors are grateful to the data analysts and research management team at Chang Gung Memorial Hospital, Taoyuan City, Taiwan who were pivotal in curating and linking the data to inform the analysis presented.

Author Contributions

All authors, Areerat Suputtitada and Carl PC Chen, contributed to conception, methodology, data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This study was supported by the Chang Gung Memorial Hospital at Linkou Research Project Grants of CMRPG5M0071 to Dr. Carl PC Chen.