Prospective case series of litigants and non-litigants with chronic spinal pain treated with dextrose prolotherapy

Abstract

Objectives

To compare outcomes for litigants and non-litigants with chronic spinal pain treated with dextrose prolotherapy.

Methods

One hundred and forty-seven consecutive patients with chronic spinal pain were classified as litigants if they had retained a lawyer for an unresolved claim at the start of treatment, or as non-litigants if they had previously settled claims or sustained non-compensable injuries. Patients were treated with a solution of 20% dextrose and 0.75% lidocaine. One-half milliliter of proliferant was injected into facet capsules of the cervical, thoracic, or lumbar spine. The iliolumbar and dorsal sacroiliac ligaments were also injected for a total of 10 cc in low back pain patients. The Neck Disability Index, Patient Specific Functional Scale, and Roland–Morris Disability Questionnaire scales were administered before treatment and approximately 1 year after treatment. At the 1-year follow-up, patients were also asked to rate their change in symptoms, function, ability to work, willingness to repeat treatment, and need for ongoing medications or other treatment.

Results

Both litigants (71) and non-litigants (76) showed significant improvement from baseline on all disability scales (P < 0.001). There were no differences in the percentage of litigants/non-litigants reporting improvement on impression of change scales for symptoms (91/92%), function (90/90%), improved ability to work (76/75%), willingness to repeat treatment (91/93%), ability to decrease medication (82/81%), and decreased need for other treatment (80/84%).

Discussion

Litigants and non-litigants with chronic spinal pain treated with prolotherapy showed statistically and clinically significant improvements in measures of disability, and impression of change scales. Litigation need not be an exclusion factor for future spine prolotherapy studies.

Keywords:

• Back pain
• Dextrose
• Litigation
• Motor vehicle accident
• Prolotherapy

Acknowledgements

The authors wish to thank Peter Faris, PhD, Biostatistician Alberta Health Services, for his advise on statistical analysis.