University of California, USA
Glenna Tolbert, M.D. is a board-certified physician who has specialized in physical medicine and rehabilitation and spinal cord injury medicine since 1993. She is founder of Center for Rehabilitation and Wellness, a state of the art facility specializing in providing comprehensive care to persons after injury or illness.
Tolbert currently is in private practice and serves as Assistant Clinical Professor of Medicine, David Geffen School of Medicine University of California, Los Angeles. She spends a significant amount of her time educating physicians, allied health care professionals, and the public about non-surgical orthopedics and neurological rehabilitation.
67 year-old female s/p L4/5, L5/S1 laminotomy presents complaining of left sacroiliac (SI) pain of 6 months duration. She failed myriad treatments. Patient began a series of PRP and prolotherapy injection therapy targeted to the left SI joint and overlying Dorsal SI Ligaments 2-4 weeks apart. Ultrasound guidance with 4MHZ curvilinear probe was used to target the treatment structures. Assessment/Results: Outcome measures and goals consisted of tolerable sitting and ability to go to the movies. Upon follow up nearly one year later, she remains "satisfied" with the results and describes "goals as met". Discussion: In recent years, there has been a growing interest towards facilitating tissue healing via bio- active substances that stimulate local growth factors involved in tissue repair. Platelet Rich Plasma (PRP) and prolotherapy, also known as regenerative injection therapy, involve injection of these bioactive substances into areas of chronic tendon, ligament and joint injury. Conclusions: Intra-articular and ligament PRP with hyperosmolar Dextrose Proliferant provided long-term pain relief, and increased function for refractory SI pain. Ultrasound guidance allows real-time accurate placement of treatment in an office setting. Additionally, this setting provides patient convenience, avoidance of X-ray exposure or other potential complications inherent to the hospital or surgical center. Further study is warranted.