Article

Low back pain is a leading cause of pain and disability. The
intervertebral disk has been identified as the most common source of chronic low
back pain. Although prior treatments directed at intervertebral disks have been
disappointing, recent studies show promising improvement of pain and function
after a single intradiskal injection of methylene blue.
OBJECTIVE: To assess
changes in pain and function in patients with diskogenic low back pain, diagnosed
by diskography, after an intradiskal injection of methylene blue.
METHODS: Patients diagnosed with diskogenic pain by
diskography underwent a single treatment of intradiskal injection of methylene
blue, determined by prior provocation diskography. MAIN OUTCOME MEASURES: Pain
and function measurements were completed at baseline and 1, 2, and 6 months after
treatment. Treatment was considered a categorical success based on a 30%
improvement in pain according to a visual analog scale (VAS) and function on the
Oswestry Disability Index (ODI). Treatment was considered a categorical failure
if less than 30% improvement in pain and function was achieved or if the patient
pursued other invasive treatment options during the trial period. RESULTS:
Sixteen patients received the intradiskal methylene blue injection. Eleven
patients received a single-level injection, 4 patients received a 2-level
injection, and one patient received injections at 3 levels. For the VAS, at 1, 2,
and 6 months after the injection, the categorical success rates were 25%, 21%,
and 25%, respectively. For the ODI, at 1, 2 and 6 months after the injection, the
categorical success rates were 25%, 21%, and 33%, respectively. The overall
categorical success rates at 1, 2, and 6 months after the injection were 19%,
21%, and 25%, respectively. CONCLUSION: This small trial did not demonstrate
overall clinical success of intradiskal methylene blue injection for patients
diagnosed with diskogenic pain by diskography.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS