Article

The objective of the current study was to compare short- and
long-term effect on chronic low back pain of intradiscal injection of
methylprednisolone with or without presence of Modic type 1 MRI changes. METHODS: Medical charts of patients receiving intradiscal injection of
methylprednisolone from January 1, 1995 to December 31, 1998 were retrospectively
reviewed. Clinical parameters were recorded at baseline, 24h after injection and
at follow-up (12-14 months). Patients were studied in three groups: Modic I-a, if
patients had Modic type 1 changes with no previous surgery or nucleolysis (n=30);
Modic I-b, if patients had Modic type 1 changes at the level of previous surgery
or nucleolysis (n=37); Control, if patients had no Modic type 1 changes (n=30).
RESULTS: Twenty-four hours after methylprednisolone injection, higher proportion
of patients with self-assessed improvement was observed in Modic I-a (90%) and
Modic I-b (71%) than in Control (30%). Low back pain decreased in both Modic
groups. Low back pain did not vary from baseline in controls. No effect was
detected in three groups, neither for radiating pain 24h after injection, nor for
any outcome parameters at the latest follow-up. CONCLUSIONS: We suggest that
patients with disabling chronic low back pain and Modic type 1 MRI changes have
specific acute response to intradiscal injection of methylprednisolone. Clinical
studies are however necessary to further investigate the effectiveness and safety
of such injections.
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Langue : ANGLAIS ; FRANCAIS