University of Vienna, Austria
Wolfgang Stelzer was a Specialist in anesthesiology, General Medicine and Intensive critical care conductor.
Patient: 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.