Prolotherapy 3

State of the Art Prolotherapy Theatre

Prolotherapy 1

Sclerosant Injections to Ligaments

Prolotherapy 2

Reduces the Risk of Recurring Back Pain

Prolotherapy 4

Neural Prolotherapy

Prolotherapy Research

Lumbar Fusion References and Comments

Nguyen, T, et al. Long-term outcomes of lumbar fusion among workers’ compensation subjects. Spine, 2010; e-pub ahead of print.
Carreon, L, et al. Clinical outcomes after posterolateral lumbar fusion in workers’ compensation patients: A case control study. Spine, 2010; 35(19):1812-7.
Magmhout-Juratli, S, et al. Lumbar fusion outcomes in Washington State Workers’ Compensation. Spine, 2006; 31(23):2715-23.
DeBerard, M, et al. Outcomes of posterolateral lumbar fusion in Utah patients receiving workers’ compensation. Spine, 2001; 26(7):738-47.
Atlas, S. Point of View, Clinical outcomes after posterolateral lumbar fusion in workers’ compensation patients: A case control study. Spine, 2010; 35(19):1818-9.
Bentsen S, Rustøen T, Wahl A, Miaskowski C. The pain experience and future expectations of chronic low back pain patients following spinal fusion. Journal of Clinical Nursing, 2008; 17(7B):153-9.

Comment
As many as 87% reported pain 1-8 years after the surgery. A high percentage of patients with CLBP continue to experience pain 1-8 years after spinal fusion.

Bentsen S, Wahl A, Strand L. Outcomes for patients with chronic low back pain treated using instrumented fusion. Scandinavian Journal of Caring Sciences, 2007; 21(1): 71-8.

Comment
16% of patients reported no pain, 17% mild pain, 29% moderate pain and 38% strong to excruciating pain following treatment using instrumented fusion (84% still in pain).

Mirza S, Deyo R. Systematic review of randomised trials comparing lumbar fusion surgery to non-operative care for treatment of chronic back pain. Spine, 2007; 32(7):816-23.

Comment
Surgery may be more efficacious than unstructured non-surgical care for chronic back pain but may not be more efficacious than structured cognitive-behaviour therapy.

Rehab as good as spinal fusion for chronic back pain. Journal of Family Practice, 2005; 54(9):752.

Robertson P, Jackson S. Prospective assessment of outcomes improvement following fusion for low back pain. Journal of Spinal Disorders & Techniques, 2004; 17(3):183-8.

Comment
Only 28.6% of patients followed achieved good or excellent low back outcome scores after fusion.

Wilson-MacDonald J. Should backache be treated with spinal fusion? The case for spinal fusion is unproved. BMJ (Clinical research ed.), 1996; 312(7022):39-40.
O’Beirne J, O’Neill D, Gallagher J, Williams D. Spinal fusion for back pain: a clinical and radiological review. Journal of Spinal Disorders, 1992; 5(1):32-38.

Authors
Dr Simon Petrides MB BS DM-SMed DO Dip Sports Med FFSEM (UK & I)
Dr John Tanner BSc MB BS FFSEM D M-S M DSMSA
Dr. Keith Bush MB BS MD (Lond) FFSEM(UK)