Ultrasound-Guided Erector Spine Muscle Hydrodissection With 10% Dextrose for Treating Chronic Low Back Pain: A Retrospective Observational Study.

Background

Chronic low back pain (CLBP) is frequently associated with dysfunction of the erector spinae (ES) muscles and thoracolumbar fascia (TLF), increasingly recognized as contributors to pain through altered biomechanics, fibrosis, and impaired fascial gliding. Ultrasound-guided hydrodissection has emerged as a minimally invasive technique to restore interfascial mobility and reduce nociceptive input. Evidence regarding higher dextrose concentrations and selective hydrodissection of the ES fascial compartments remains limited.

Objective

To evaluate the safety and clinical effectiveness of ultrasound-guided ES hydrodissection using 10% dextrose in patients with CLBP, and to compare outcomes between surgical and non-surgical patients.

Methods

This retrospective observational study included 40 patients with CLBP (> 3 months) localized to the ES muscles. All patients underwent three ultrasound-guided hydrodissection sessions at 14-day intervals using 10% dextrose with lidocaine. Pain intensity (NRS), functional disability (ODI), and muscle quality (Heckmatt score) were assessed at baseline and up to 3 months follow-up.

Results

Mean NRS decreased from 7.58 to 3.27 at 3 months (-56.9%). Mean ODI improved from 54.00 to 27.82 (-46.4%). Non-surgical patients showed greater improvements in pain (-82.5%) and disability (-74.9%) compared to post-surgical patients (-39.4% and -33.5%, respectively). No significant adverse events were observed.

Conclusions

Ultrasound-guided ES hydrodissection with 10% dextrose is a safe and effective treatment for CLBP, producing clinically meaningful reductions in pain and disability, particularly in non-surgical patients. Further controlled studies are warranted to confirm long-term efficacy.