Open AccessCase Series on Chronic Whiplash Related Neck Pain Treated with Intraarticular Zygapophysial Joint Regeneration Injection Therapy
Author(s) -
Hooper Ra,
Frizzell Jb,
Peter Faris
Publication year - 2007
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2007/10/313
Subject(s) - medicine , whiplash , neck pain , prolotherapy , surgery , lidocaine , manual therapy , poison control , alternative medicine , environmental health , pathology
Background: Although in clinical use, there is only 1 published case report on the efficacy of intraarticular regeneration injection therapy (RIT) (a.k.a. prolotheraphy). This report supports a rationale for future clinical trials of this technique.Objective: To assess the efficacy of intraarticular zygapophysial joint RIT in patientswith chronic whiplash related neck pain that failed other conservative and interventionalprocedures. Patients were treated with intraarticular RIT and reassessed over 1 year.Design: Retrospective case review of prospective data.Materials and Methods: Eighteen consecutive patients were treated withintraarticular prolotherapy by placing 0.5 – 1mL of 20% dextrose solution into each zygapophysial joint, after confirmation of intraarticular location with radiographic contrast,using 25-gauge spinal needles and fluoroscopic guidance. Solution was prepared by diluting D50W with 1% lidocaine.Results: Fifteen patients completed treatment. Three patients had bilateral treatment, leaving 18 sides for analysis. Mean Neck Disability Index (NDI) pre-treatment was24.71 and decreased post-treatment to 14.21 (2 months), 13.45 (6 months), 10.94 (12months). Average change NDI=13.77 (p<0.0001) baseline versus 12 months. Symptomsfor 14 patients were from motor vehicle accident, of which 13 were in litigation. Patientsattending physiotherapy over the course of treatment had better outcomes than thosewithout physiotherapy. Women needed more injections (5.4) than men (3.2) p=0.0003.Conclusion: Intraarticular RIT improved pain and function in this case series. The procedure appears safe, more effective than periarticular RIT, and lasted as long, or longer,than those patients with previous radiofrequency neurotomy. Concurrent physiotherapyhelped reduce post-procedure neck stiffness. Future trials should consider gender whendeciding how many treatments to administer. Litigation was not a barrier to recovery.Key words: regenerative injection therapy, RIT, prolotherapy, zygapophysial joint, motor vehicle accident, whiplash