Background: Degenerative discs are thought to produce nerve root pain either mechanically or chemically. Particularly in the case of advanced degenerative disc disease, this clinical entity has often proven to be symptomatically resistant to peridural steroids, Intra-discal Electrothermoplasty (IDET) and direct surgical intervention. Exposure of irritated nerves to hypertonic dextrose is thought to have chemoneuromodulatory potential. Sustained pain reduction has been demonstrated in a pilot study involving injection of a combination of dextrose, glucosamine, chondroitin and dimethylsulfoxide into degenerative discs of patients with chronic low back pain of discogenic origin.
Objective: To assess the effects of disc space injections of hypertonic dextrose in patients experiencing chronic advanced degenerative discogenic leg pain, with or without low back pain.
Study Design: Prospective consecutive patient series.
Methods: Patients with moderate to severe degenerative disc disease without herniation and with concordant pain reproduction with CT discography were included. All had failure of a physical therapy trial and substantial but temporary relief with two fluoroscopically guided epidural steroid injections. Patients underwent bi-weekly disc space injection of a solution consisting of 50% dextrose and 0.25% Bupivacaine in the disc(s) found positive on discography. The study was performed in an out-patient surgery center in the United States. Outcome measures included an 11-scale numeric pain score (0-10).
Results: Each patient was injected an average of 3.5 times. Overall, 43.4% of patients fell into the sustained improvement group with an average improvement in numeric pain scores of 71%, comparing pretreatment and 18 month measurements.
Conclusion: The results suggest that intradiscal injection of hypertonic dextrose may have a place in the management of pain arising from advanced lumbar degenerative disc disease.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Altered Cellular Metabolism Is a Consequence of Loss of the Ataxia-Linked Protein Sacsin.
Int J Mol Sci
December 2024
William Harvey Research Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK.
Mitochondrial dysfunction is implicated in the pathogenesis of the neurological condition autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS), yet precisely how the mitochondrial metabolism is affected is unknown. Thus, to better understand changes in the mitochondrial metabolism caused by loss of the sacsin protein (encoded by the SACS gene, which is mutated in ARSACS), we performed mass spectrometry-based tracer analysis, with both glucose- and glutamine-traced carbon. Comparing the metabolite profiles between wild-type and sacsin-knockout cell lines revealed increased reliance on aerobic glycolysis in sacsin-deficient cells, as evidenced by the increase in lactate and reduction of glucose.
View Article and Find Full Text PDFShikonin protects mitochondria through the NFAT5/AMPK pathway for the treatment of diabetic wounds.
World J Diabetes
December 2024
School of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou 310023, Zhejiang Province, China.
Background: Shikonin is a natural remedy that is effective at treating diabetic wounds. NFAT5 is a potential therapeutic target for diabetes, and mitochondrial function is essential for wound healing. However, the relationship among Shikonin, NFAT5, and mitochondrial function has not been thoroughly studied.
View Article and Find Full Text PDFRectal Prolapse in the Pediatric Population.
Curr Gastroenterol Rep
December 2025
Northwell, Cohen Children's Medical Center, Division of Pediatric General, Thoracic, and Endoscopic Surgery, Northwell Health, 2000 Marcus Ave, Suite 300, New Hyde Park, NY, 11042-1069, USA.
Purpose Of Review: Rectal prolapse in the pediatric population presents a clinical challenge with wide variability in etiology, presentation, work-up and management. In this article, we reviewed the evidence supporting various medical and surgical treatment options as well as the recent trends amongst pediatric surgeons.
Recent Findings: Medical therapy is highly effective in most patients, with bowel management programs being particularly successful.
Prolotherapy in the Treatment of Sports-Related Tendinopathies: A Systematic Review of Randomized Controlled Trials.
Orthop J Sports Med
November 2024
Department of Orthopedics and Rehabilitation, Stony Brook University Hospital, Stony Brook, New York, USA.
Background: As sports have increased in popularity, the incidence of tendinopathy has also grown dramatically. Nonoperative techniques and treatments used to address these pathologies continue to evolve and improve. One such treatment, prolotherapy (PrT), has become increasingly popular and may provide patients with an alternative nonoperative treatment option.
View Article and Find Full Text PDFEfficacy of dextrose prolotherapy on temporomandibular disorder: a retrospective study.
J Korean Assoc Oral Maxillofac Surg
October 2024
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
Objectives: Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms.
Materials And Methods: A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!