Treatment of failed back surgery syndrome with regional sugar water injections: A clinical case report
Main Article Content
Abstract
Failed back surgery syndrome is a chronic pain condition that persists despite or after surgical intervention. It presents a disabling condition that is difficult to manage. Over the last decade, regional sugar water injections have become popular for the treatment of musculoskeletal and neuropathic pain syndromes. This article describes the case of a patient with persistent pseudo-sciatica despite surgery who underwent multiple sessions of sugar water injections. This study aimed to share this experience with the global medical community. Further clinical investigations are required to confirm whether this novel approach can effectively treat patients with this condition.
Keywords:
sugar water injections, failed back surgery syndrome, D5W, glucopuncture, sacroiliac ligament, gluteus minimus trigger point, pseudosciatica
Article Details
How to Cite
KERSSCHOT, Jan et al.
Treatment of failed back surgery syndrome with regional sugar water injections: A clinical case report.
Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4889>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i12.4889.
Section
Case Reports
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Orhurhu VJ, Chu R, Gill J. Failed back surgery syndrome. 2020 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
2. Weigel R, Capelle HH, Al-Afif S, Krauss JK. The dimensions of "failed back surgery syndrome": what is behind a label? Acta Neurochir (Wien). 2021;163(1):245-250.
3. Alizadeh R, Sharifzadeh SR. Pathogenesis, etiology and treatment of failed back surgery syndrome. Neurochirurgie. 2022;68(4):426-431.
4. Xu W, Ran B, Zhao J, Luo W, Gu R. Risk factors for failed back surgery syndrome following open posterior lumbar surgery for degenerative lumbar disease. BMC Musculoskelet Disord. 2022 31;23(1):1141.
5. Chen YC, Lee CY, Chen SJ. Narcotic addiction in failed back surgery syndrome. Cell Transplant. 2019;28(3):239-247.
6. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J. 2019;28(7):1610-1617.
7. Tomycz ND, Ortiz V, Moossy JJ. Simultaneous intrathecal opioid pump and spinal cord stimulation for pain management: analysis of 11 patients with failed back surgery syndrome. J Pain Palliat Care Pharmacother. 2010;24(4):374-83.
8. Tapias Pérez JH. Spinal cord stimulation: beyond pain management. Neurologia (Engl Ed). 2022 Sep;37(7):586-595.
9. Maniquis-Smigel L, Dean Reeves K, Jeffrey Rosen H, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Short term analgesic effects of 5% dextrose epidural injections for chronic low back pain: A randomized controlled trial. Anesth Pain Med. 2016; 6(1):425504.
10. Pandey N, Nayak P, Gahnolia V. A randomized control trial on efficacy of analgesic effect of 5% dextrose caudal epidural injection for non-specific low back pain. International Journal of Scientific Research. 2021;10(9):11-13.
11. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-guided nerve hydrodissection for pain management: Rationale, methods, current literature, and theoretical mechanisms. J Pain Res. 2020; 4(13):1957-1968.
12. Kersschot J. Glucopuncture for rotator cuff related shoulder pain: an alternative for cortisone? Clin Rev Cases. 2022; 4(2):1-4.
13. Kersschot J, Karavani I. Isotonic glucose injections for postherpetic neuralgia in the elderly. Cureus. 2022;14(9):29740.
14. Kersschot J, Mathieu T. Treatment of painless nodules with glucopuncture in dupuytren's disease in men: A clinical case. Cureus. 2022;14(11):31445.
15. Kim MY, Na YM, Moon JH. Comparison on treatment effects of dextrose water, saline and lidocaine for trigger point injection. J Korean Acad Rehab Med 1997;21:967-973.
16. Lyftogt J. Prolotherapy and Achilles tendinopathy: a prospective pilot study of an old treatment. Australas Musculoskel Med. 2005;10:16-19.
17. Wu YT, Ke MJ, Ho TY, Li TY, Shen YP, Chen LC. Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients. Ann Neurol. 2018; 84(4): 601-610.
18. Wu YT, Ho TY, Chou YC, Ke MJ, Li TY, Tsai CK, Chen LC. Six-month efficacy of perineural dextrose for carpal tunnel syndrome: A prospective, randomized, double-blind, controlled trial. Mayo Clin Proc. 2017;92(8):1179-1189.
19. Ho TY, Chen SR, Li TY, Li CY, Lam KHS, Chen LC, Md YW. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. Int J Med Sci. 2021;18(9):1960-1965.
20. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J. 2019;28(7):1610-1617.
21. Maniquis-Smigel L, Dean Reeves K, Jeffrey Rosen H, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Short term analgesic effects of 5% dextrose epidural injections for chronic low back pain: A randomized controlled trial. Anesth Pain Med. 2016;6 (1):e42550.
22. Pandey N, Nayak P, Gahnolia V. A randomized control trial on efficacy of analgesic effect of 5% dextrose caudal epidural injection for non-specific low back pain. International Journal of Scientific Research. 2021;10 (9):11-13.
23. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-guided nerve hydrodissection for pain management: rationale, methods, current literature, and theoretical mechanisms. J Pain Res. 2020;4(13):1957-1968.
24. Lam KHS, Lai WW, Ngai HY, Wu WKR. Practical considerations for ultrasound-guided hydrodissection in pronator teres syndrome. Pain Med. 2022;23(1):221-223.
25. Lam KHS, Lai WW, Ngai HY, Wu WKR, Wu YT. Comment on the safety of the ultrasound-guided hydrodissection technique for carpal tunnel syndrome. J Ultrasound. 2022:1-3
26. Ferrie J, Kersschot J, Treatment of lateral ankle pain with glucopuncture: A clinical case. World Journal of Advanced Research and Reviews, 2023;19(01):1012-1016.
27. Kersschot J, Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case. Medical Research Archives. 2023:11(8).
28. Kersschot J, Laverde D, Treatment of grade 1 hamstring injury with glucopuncture: a clinical case. World Journal of Advanced Research and Reviews. 2023;19(03):1084-1089.
29. Cherng J-H, Chang S-J, Tsai H-D, Chun C-F, Fan G-Y, Reeves KD, Lam KHS, Wu Y-T. The potential of glucose treatment to reduce reactive oxygen species production and apoptosis of inflamed neural cells in vitro. Biomedicines. 2023;11(7):1837.
30. Lam KHS, Su DCJ, Wu Y-T, Fajardo Pérez M, Reeves KD, Peng P, Fullerton B. Infraspinatus fascial dysfunction as a cause of painful anterior shoulder snapping: its visualization via dynamic ultrasound and its resolution via diagnostic ultrasound-guided injection. Diagnostics. 2023;13(15):2601.
31. Amanollahi A, Asheghan M, Hashemi S. Subacromial corticosteroid injection versus subcutaneous 5% dextrose in patients with chronic rotator cuff tendinopathy: A short-term randomized clinical trial. Interventional Medicine and Applied Science IMAS. 2020;11(3):154-160.
32. Chen LC, Ho TY, Shen YP, Su YC, Li TY, Tsai CK, Wu YT. Perineural dextrose and corticosteroid injections for ulnar neuropathy at the elbow: A randomized double-blind trial. Arch Phys Med Rehabil. 2020;101(8):1296-1303.
33. Mansiz-Kaplan B, Nacir B, Pervane-Vural S, Tosun-Meric O, Duyur-Cakit B, Genc H. Effect of perineural dextrose injection on ulnar neuropathy at the elbow: A randomized, controlled, double-blind study. Arch Phys Med Rehabil. 2022;103(11):2085-2091.
34. Wu YT, Ke MJ, Ho TY, Li TY, Shen YP, Chen LC. Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients. Ann Neurol. 2018;84(4):601-610.
35. Babaei-Ghazani A, Moradnia S, Azar M, Forogh B, Ahadi T, Chaibakhsh S, Khodabandeh M, Eftekharsadat B. Ultrasound-guided 5% dextrose prolotherapy versus corticosteroid injection in carpal tunnel syndrome: a randomized, controlled clinical trial. Pain Manag. 2022;12(6):687-697.
36. Nasiri A, Motlagh FR, Vafaei MA, Efficacy comparison between ultrasound-guided injections of 5% dextrose with corticosteroids in carpal tunnel syndrome patients, Neurological Research 2023;8:1-10
37. Lam KHS, Wu YT, Reeves KD, Galluccio F, Allam AE, Peng PWH. Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses. Diagnostics (Basel) 2023 Mar 16;13(6):1138
38. Kersschot J, Glucopuncture: A clinical guide to regional glucose 5% injections. B P International (India/UK). 2023:16-18
39. Hammi C, Schroeder JD, Yeung B. Trigger point injection. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
40. Appasamy M, Lam C, Alm J, Chadwick AL. Trigger point injections. Phys Med Rehabil Clin N Am. 2022;33(2):307-333.
41. Fairbank JC, Pynsent PB. The oswestry disability index. Spine. 2000:25(22):2940-2952
42. Podesta L, Honbo ES, Mattfeld R, Khadavi M. Orthobiologic treatment of ligament injuries. Phys Med Rehabil Clin N Am. 2023;34(1):135-163.
43. Gyimesi G, Pujol-Giménez J, Kanai Y, Hediger MA. Sodium-coupled glucose transport, the SLC5 family, and therapeutically relevant inhibitors: from molecular discovery to clinical application. Pflugers Arch. 2020; 472(9):1177-1206.
44. Jurcovicova J. Glucose transport in brain - effect of inflammation. Endocr Regul. 2014; 48(1):35-48.
45. Pragallapati S, Manyam R. Glucose transporter 1 in health and disease. J Oral Maxillofac Pathol. 2019;23(3):443-449.
46. Gyimesi G, Pujol-Giménez J, Kanai Y, Hediger MA. Sodium-coupled glucose transport, the SLC5 family, and therapeutically relevant inhibitors: from molecular discovery to clinical application. Pflugers Arch. 2020; 472(9):1177-1206.
47. Jurcovicova J. Glucose transport in brain - effect of inflammation. Endocr Regul. 2014; 48(1):35-48.
48. Pragallapati S, Manyam R. Glucose transporter 1 in health and disease. J Oral Maxillofac Pathol. 2019;23(3):443-449.
49. Wu D, Lee S, Luo J, Xia H, Gushchina S, Richardson PM, Yeh J, Krügel U, Franke H, Zhang Y, Bo X. Intraneural injection of ATP stimulates regeneration of primary sensory axons in the spinal cord. J Neurosci. 2018;38(6):1351-1365.
50. Moriyama M, Kitamura A, Ikezaki H, Nakanishi K, Kim C, Sakamoto A, Ogawa R. Systemic ATP infusion improves spontaneous pain and tactile allodynia, but not tactile hypesthesia, in patients with postherpetic neuralgia. J Anesth. 2004;18(3):177-80.
51. Hayashida M, Fukuda K, Fukunaga A, Meno A, Sato K, Tarui K, Arita H, Kaneko Y, Hanaoka K. Analgesic effect of intravenous ATP on postherpetic neuralgia in comparison with responses to intravenous ketamine and lidocaine. J Anesth. 2005;19(1):31-5.
2. Weigel R, Capelle HH, Al-Afif S, Krauss JK. The dimensions of "failed back surgery syndrome": what is behind a label? Acta Neurochir (Wien). 2021;163(1):245-250.
3. Alizadeh R, Sharifzadeh SR. Pathogenesis, etiology and treatment of failed back surgery syndrome. Neurochirurgie. 2022;68(4):426-431.
4. Xu W, Ran B, Zhao J, Luo W, Gu R. Risk factors for failed back surgery syndrome following open posterior lumbar surgery for degenerative lumbar disease. BMC Musculoskelet Disord. 2022 31;23(1):1141.
5. Chen YC, Lee CY, Chen SJ. Narcotic addiction in failed back surgery syndrome. Cell Transplant. 2019;28(3):239-247.
6. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J. 2019;28(7):1610-1617.
7. Tomycz ND, Ortiz V, Moossy JJ. Simultaneous intrathecal opioid pump and spinal cord stimulation for pain management: analysis of 11 patients with failed back surgery syndrome. J Pain Palliat Care Pharmacother. 2010;24(4):374-83.
8. Tapias Pérez JH. Spinal cord stimulation: beyond pain management. Neurologia (Engl Ed). 2022 Sep;37(7):586-595.
9. Maniquis-Smigel L, Dean Reeves K, Jeffrey Rosen H, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Short term analgesic effects of 5% dextrose epidural injections for chronic low back pain: A randomized controlled trial. Anesth Pain Med. 2016; 6(1):425504.
10. Pandey N, Nayak P, Gahnolia V. A randomized control trial on efficacy of analgesic effect of 5% dextrose caudal epidural injection for non-specific low back pain. International Journal of Scientific Research. 2021;10(9):11-13.
11. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-guided nerve hydrodissection for pain management: Rationale, methods, current literature, and theoretical mechanisms. J Pain Res. 2020; 4(13):1957-1968.
12. Kersschot J. Glucopuncture for rotator cuff related shoulder pain: an alternative for cortisone? Clin Rev Cases. 2022; 4(2):1-4.
13. Kersschot J, Karavani I. Isotonic glucose injections for postherpetic neuralgia in the elderly. Cureus. 2022;14(9):29740.
14. Kersschot J, Mathieu T. Treatment of painless nodules with glucopuncture in dupuytren's disease in men: A clinical case. Cureus. 2022;14(11):31445.
15. Kim MY, Na YM, Moon JH. Comparison on treatment effects of dextrose water, saline and lidocaine for trigger point injection. J Korean Acad Rehab Med 1997;21:967-973.
16. Lyftogt J. Prolotherapy and Achilles tendinopathy: a prospective pilot study of an old treatment. Australas Musculoskel Med. 2005;10:16-19.
17. Wu YT, Ke MJ, Ho TY, Li TY, Shen YP, Chen LC. Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients. Ann Neurol. 2018; 84(4): 601-610.
18. Wu YT, Ho TY, Chou YC, Ke MJ, Li TY, Tsai CK, Chen LC. Six-month efficacy of perineural dextrose for carpal tunnel syndrome: A prospective, randomized, double-blind, controlled trial. Mayo Clin Proc. 2017;92(8):1179-1189.
19. Ho TY, Chen SR, Li TY, Li CY, Lam KHS, Chen LC, Md YW. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. Int J Med Sci. 2021;18(9):1960-1965.
20. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J. 2019;28(7):1610-1617.
21. Maniquis-Smigel L, Dean Reeves K, Jeffrey Rosen H, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Short term analgesic effects of 5% dextrose epidural injections for chronic low back pain: A randomized controlled trial. Anesth Pain Med. 2016;6 (1):e42550.
22. Pandey N, Nayak P, Gahnolia V. A randomized control trial on efficacy of analgesic effect of 5% dextrose caudal epidural injection for non-specific low back pain. International Journal of Scientific Research. 2021;10 (9):11-13.
23. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-guided nerve hydrodissection for pain management: rationale, methods, current literature, and theoretical mechanisms. J Pain Res. 2020;4(13):1957-1968.
24. Lam KHS, Lai WW, Ngai HY, Wu WKR. Practical considerations for ultrasound-guided hydrodissection in pronator teres syndrome. Pain Med. 2022;23(1):221-223.
25. Lam KHS, Lai WW, Ngai HY, Wu WKR, Wu YT. Comment on the safety of the ultrasound-guided hydrodissection technique for carpal tunnel syndrome. J Ultrasound. 2022:1-3
26. Ferrie J, Kersschot J, Treatment of lateral ankle pain with glucopuncture: A clinical case. World Journal of Advanced Research and Reviews, 2023;19(01):1012-1016.
27. Kersschot J, Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case. Medical Research Archives. 2023:11(8).
28. Kersschot J, Laverde D, Treatment of grade 1 hamstring injury with glucopuncture: a clinical case. World Journal of Advanced Research and Reviews. 2023;19(03):1084-1089.
29. Cherng J-H, Chang S-J, Tsai H-D, Chun C-F, Fan G-Y, Reeves KD, Lam KHS, Wu Y-T. The potential of glucose treatment to reduce reactive oxygen species production and apoptosis of inflamed neural cells in vitro. Biomedicines. 2023;11(7):1837.
30. Lam KHS, Su DCJ, Wu Y-T, Fajardo Pérez M, Reeves KD, Peng P, Fullerton B. Infraspinatus fascial dysfunction as a cause of painful anterior shoulder snapping: its visualization via dynamic ultrasound and its resolution via diagnostic ultrasound-guided injection. Diagnostics. 2023;13(15):2601.
31. Amanollahi A, Asheghan M, Hashemi S. Subacromial corticosteroid injection versus subcutaneous 5% dextrose in patients with chronic rotator cuff tendinopathy: A short-term randomized clinical trial. Interventional Medicine and Applied Science IMAS. 2020;11(3):154-160.
32. Chen LC, Ho TY, Shen YP, Su YC, Li TY, Tsai CK, Wu YT. Perineural dextrose and corticosteroid injections for ulnar neuropathy at the elbow: A randomized double-blind trial. Arch Phys Med Rehabil. 2020;101(8):1296-1303.
33. Mansiz-Kaplan B, Nacir B, Pervane-Vural S, Tosun-Meric O, Duyur-Cakit B, Genc H. Effect of perineural dextrose injection on ulnar neuropathy at the elbow: A randomized, controlled, double-blind study. Arch Phys Med Rehabil. 2022;103(11):2085-2091.
34. Wu YT, Ke MJ, Ho TY, Li TY, Shen YP, Chen LC. Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients. Ann Neurol. 2018;84(4):601-610.
35. Babaei-Ghazani A, Moradnia S, Azar M, Forogh B, Ahadi T, Chaibakhsh S, Khodabandeh M, Eftekharsadat B. Ultrasound-guided 5% dextrose prolotherapy versus corticosteroid injection in carpal tunnel syndrome: a randomized, controlled clinical trial. Pain Manag. 2022;12(6):687-697.
36. Nasiri A, Motlagh FR, Vafaei MA, Efficacy comparison between ultrasound-guided injections of 5% dextrose with corticosteroids in carpal tunnel syndrome patients, Neurological Research 2023;8:1-10
37. Lam KHS, Wu YT, Reeves KD, Galluccio F, Allam AE, Peng PWH. Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses. Diagnostics (Basel) 2023 Mar 16;13(6):1138
38. Kersschot J, Glucopuncture: A clinical guide to regional glucose 5% injections. B P International (India/UK). 2023:16-18
39. Hammi C, Schroeder JD, Yeung B. Trigger point injection. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
40. Appasamy M, Lam C, Alm J, Chadwick AL. Trigger point injections. Phys Med Rehabil Clin N Am. 2022;33(2):307-333.
41. Fairbank JC, Pynsent PB. The oswestry disability index. Spine. 2000:25(22):2940-2952
42. Podesta L, Honbo ES, Mattfeld R, Khadavi M. Orthobiologic treatment of ligament injuries. Phys Med Rehabil Clin N Am. 2023;34(1):135-163.
43. Gyimesi G, Pujol-Giménez J, Kanai Y, Hediger MA. Sodium-coupled glucose transport, the SLC5 family, and therapeutically relevant inhibitors: from molecular discovery to clinical application. Pflugers Arch. 2020; 472(9):1177-1206.
44. Jurcovicova J. Glucose transport in brain - effect of inflammation. Endocr Regul. 2014; 48(1):35-48.
45. Pragallapati S, Manyam R. Glucose transporter 1 in health and disease. J Oral Maxillofac Pathol. 2019;23(3):443-449.
46. Gyimesi G, Pujol-Giménez J, Kanai Y, Hediger MA. Sodium-coupled glucose transport, the SLC5 family, and therapeutically relevant inhibitors: from molecular discovery to clinical application. Pflugers Arch. 2020; 472(9):1177-1206.
47. Jurcovicova J. Glucose transport in brain - effect of inflammation. Endocr Regul. 2014; 48(1):35-48.
48. Pragallapati S, Manyam R. Glucose transporter 1 in health and disease. J Oral Maxillofac Pathol. 2019;23(3):443-449.
49. Wu D, Lee S, Luo J, Xia H, Gushchina S, Richardson PM, Yeh J, Krügel U, Franke H, Zhang Y, Bo X. Intraneural injection of ATP stimulates regeneration of primary sensory axons in the spinal cord. J Neurosci. 2018;38(6):1351-1365.
50. Moriyama M, Kitamura A, Ikezaki H, Nakanishi K, Kim C, Sakamoto A, Ogawa R. Systemic ATP infusion improves spontaneous pain and tactile allodynia, but not tactile hypesthesia, in patients with postherpetic neuralgia. J Anesth. 2004;18(3):177-80.
51. Hayashida M, Fukuda K, Fukunaga A, Meno A, Sato K, Tarui K, Arita H, Kaneko Y, Hanaoka K. Analgesic effect of intravenous ATP on postherpetic neuralgia in comparison with responses to intravenous ketamine and lidocaine. J Anesth. 2005;19(1):31-5.