Mechanical Needling With Sterile Water Versus Lidocaine Injection for Lumbar Spinal Stenosis

Abstract

Study Design: This was a retrospective observational study that assessed the clinical outcome of ageing patients who received ultrasound-guided (USG) mechanical needling with sterile water injection. In addition, the clinical outcome of age-and gender matched patients randomly selected from patients who received needling with sterile water was compared to the patients injected with lidocaine in a 1:1 ratio.Objective: This present study aimed to explore the clinical effects of USG mechanical needling with sterile water injection for lumbar spinal stenosis (LSS).Methods: The data was extracted from the medical records of ageing patients with LSS who received USG injection at the lumbosacral spine by the first author. Low back pain or axial pain, and leg pain or radicular pain were assessed by the visual analogue scale, and gait ability with walking distance were obtained at six different time points.Results: A total of 4328 medical records were examined. Four thousand two hundred and twenty-eight ageing patients received mechanical needling with sterile water injection and found the efficacy lasted up to 6 months. One hundred patients were compared with 100 patients who received lidocaine injection. Those who received lidocaine had pain returned at 3 months and 6 months post-injection.Conclusions: USG mechanical needling with sterile water injection could help relieve axial and radicular pain for at least 6 months. Removal of calcification and fibrosis as well as reduction of sensitization are all possible mechanisms.

Keywords: calcification; fibrosis; lumbar spinal stenosis; mechanical needling; pain; sterile water.

Figure 1.

Strengthening the reporting of observational studies in epidemiology flow chart.

Figure 2.

The comparison within group (A) and between groups (B) of visual analogue scale for back pain (axial pain) at 6-time points as pre-injection (T0), immediately (T1), one week (T2), 1-month post-injection (T3), 3-month (T4), and 6-month (T5).

Figure 3.

The comparison within group (A) and between groups (B) of visual analogue scale for leg pain (radicular pain) at 6-time points as pre-injection (T0), immediately (T1), one week (T2), 1-month (T3), 3-month (T4), and 6-month (T5).

Figure 4.

The comparison within group (A) and between groups (B) of walking distance (metres) at 6-time points as pre-injection (T0), immediately (T1), one week (T2), 1-month (T3), 3-month (T4), and 6-month (T5).