Ultrasound-Guided Nerve Hydrodissection for the Management of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis

Ulnar Neuropathy Hydrodissection With Platelet Lysate and Prolotherapy: A Case Series and Review of the Literature

This case series highlights both pain and function outcomes of three patients who underwent hydrodissection of the ulnar nerve with platelet lysate and prolotherapy for symptomatic ulnar nerve entrapment of the elbow. All patients reported significant long-term symptom improvement, which reached more than 75% regarding pain and function and greater than 80% Single Assessment Numeric Evaluation (SANE) evaluation at the follow-up. The outcomes of this case series suggest that hydrodissection with platelet lysate and dextrose neuroprolotherapy may provide an alternative viable non-surgical treatment option for patients with ulnar neuropathy.

A Novel Therapeutic Approach Targeting Spinal Accessory and Dorsal Scapular Nerves for the Relief of Posterior Neck, Trapezius, and Interscapular Pain

Background/Objectives: Posterior neck, trapezius, and interscapular pain, exacerbated by poor posture such as forward head and rounded shoulders, is common. In this study, we aimed to assess the clinical outcomes of isotonic saline injections at nerve entrapment points (NEPs) within the sternocleidomastoid (SCM) and scalenus medius (SM) muscles for alleviating spinal accessory nerve (SAN) and dorsal scapular nerve (DSN) compression in patients suffering from posterior neck, trapezius, and interscapular pain. Methods: In this retrospective study, 68 patients were included, with 34 receiving isotonic saline injections and 34 undergoing Extracorporeal Shock Wave Therapy (ESWT) as a control. The clinical outcomes were evaluated using the Visual Analog Scale (VAS) and Percent Pain Intensity Difference (PPID) before and after therapy. The effectiveness of isotonic saline injections targeting NEPs in the SCM and SM muscles in relieving pain associated with SAN and DSN entrapment was assessed. Results: Both treatments significantly reduced VAS and PPID scores, with injection therapy showing a larger treatment effect size (Cohen's d: 3.521 for VAS and 3.521 for PPID) compared to ESWT (Cohen's d: 1.379 for VAS and 1.710 for PPID). The mean clinically important difference observed for VAS was 4.2, exceeding the expected value of 2.6, indicating a substantial improvement in pain and patient quality of life. Conclusions: Isotonic saline injections at the NEPs of SAN and DSN within the SCM and SM muscles might potentially reduce posterior neck, trapezius, and interscapular pain associated with possible nerve entrapment, without causing complications. Further research is needed to validate these findings in larger, controlled trials.