scholarly journals Prospective Clinical Study on Natural History of Discogenic Low Back Pain at 4 Years of Follow-up

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. 525-532
Author(s):  
Baogan Peng
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Study ◽  
Natural History ◽  
Prospective Clinical Study ◽  
Low Back ◽  
Discogenic Low Back Pain ◽  
History Of ◽  
Pain Symptoms

Background: To accurately assess the effect of any therapy for treating discogenic low back pain, the natural history of such pain should be known beforehand. However, until now, no pathological characteristic could be used to predict the disease course of low back pain. Objective: To better instruct the clinical treatment of discogenic low back pain, a prospective clinical study was performed to observe the natural history of the disease. Study Design: A prospective clinical study during a 4-year follow-up period. Setting: The study was performed at a spinal center in China. Methods: A total of 279 patients with chronic low back pain were included from June 2006 through October 2007. Using discography, 156 patients (56%) were diagnosed to have discogenic back pain. A 101-point numerical rating scale (NRS) was used to assess the back pain symptoms and the Oswestry Disability Index (ODI) was used to assess lumbar function. Results: Of the 156 patients, 131 (84%) completed the study at 4-year follow-up. At the end of follow-up, 17 patients (13.0%) had their low back pain symptoms alleviated and lumbar function improved; 10 patients (7.6%) were slightly improved; 16 patients (12.2%) had their symptoms aggravated; and 88 patients (67.2%) experienced the same pain and disability as before. Although the average NRS and ODI scores obtained during the 4-year follow-up study gradually decreased, statistical significances were found in such changes (P < 0.05,and P < 0.05, respectively); however, the improvement rates of both pain (7.6%) and disability (5.2%) were very low. Limitations: The shortcoming of this study is its relatively small sample size. Conclusion: The present study indicated that the natural history of discogenic low back pain was chronic but persistent, and that the pain and disability in most patients did not improve over time. Key words: Discogenic low back pain, chronic low back pain, lumbar discography, painful disc, black disc, disc degeneration, internal disc disruption, natural history, prognosis.

scholarly journals Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

2017 ◽  
Vol 11 (3) ◽  
pp. 380-389 ◽  
Author(s):  
Koji Akeda ◽  
Kohshi Ohishi ◽  
Koichi Masuda ◽  
Won C. Bae ◽  
Norihiko Takegami ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Low Back ◽  
Discogenic Low Back Pain ◽  
Intradiscal Injection ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

<sec><title>Study Design</title><p>Preliminary clinical trial.</p></sec><sec><title>Purpose</title><p>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</p></sec><sec><title>Overview of Literature</title><p>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</p></sec><sec><title>Methods</title><p>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</p></sec><sec><title>Results</title><p>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic>&lt;0.01, respectively). The mean T2 values did not significantly change after treatment.</p></sec><sec><title>Conclusions</title><p>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</p></sec>

scholarly journals Lumbosacral Liposuction. A New Tool for the Treatment of Low Back Pain

2007 ◽  
Vol 13 (2) ◽  
pp. 153-160 ◽  
Author(s):  
J. Théron ◽  
L. Guimaraens ◽  
A. Casasco ◽  
H. Coellar ◽  
T. Sola
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
New Technique ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Paraspinal Muscles ◽  
A New Technique ◽  
Pain Symptoms

To obtain a better active contention of the lumbosacral spine, a new technique of liposuction of the fat surrounding the atrophied paraspinal muscles is described. A preliminary series of 40 patients presenting low back pain symptoms is presented. The technique, performed on an out patient basis is well tolerated. The MR follow-up controls regularly showed an expansion of the paraspinal muscles. The overall results obtained on this preliminary non uniform series showed encouraging results with 77.5% of very good or good results.

A Double-blind, Placebo-controlled, Dose–Response Pilot Study Evaluating Intradiscal Etanercept in Patients with Chronic Discogenic Low Back Pain or Lumbosacral Radiculopathy

2007 ◽  
Vol 107 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Steven P. Cohen ◽  
Daniel Wenzell ◽  
Robert W. Hurley ◽  
Connie Kurihara ◽  
Chester C. Buckenmaier ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Double Blind ◽  
Pain Scores ◽  
Discogenic Low Back Pain ◽  
Leukocyte Counts ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background: In recent years, convincing evidence has emerged implicating tumor necrosis factor α as a causative factor in radiculopathy and discogenic back pain. But although preliminary open-label studies demonstrated promising results for the treatment of low back pain with tumor necrosis factor-α inhibitors, early optimism has been tainted by a controlled study showing no significant benefit in sciatica. To determine whether outcomes might be improved by a more direct route of administration, the authors evaluated escalating doses of intradiscal etanercept in 36 patients with chronic lumbosacral radiculopathy or discogenic low back pain. Methods: A double-blind, placebo-controlled pilot study was conducted whereby six patients received 0.1, 0.25, 0.5, 0.75, 1.0, or 1.5 mg etanercept intradiscally in each pain-generating disc. In each escalating dose group of six patients, one received placebo. A neurologic examination and postprocedure leukocyte counts were performed in all patients at 1-month follow-up visits. In patients who experienced significant improvement in pain scores and function, follow-up visits were conducted 3 and 6 months after the procedure. Results: At 1-month follow-up, no differences were found for pain scores or disability scores between or within groups for any dose range or subgroup of patients. Only eight patients remained in the study after 1 month and elected to forego further treatment. No complications were reported, and no differences were noted between preprocedure and postprocedure leukocyte counts. Conclusions: Although no serious side effects were observed in this small study, a single low dose of intradiscal etanercept does not seem to be an effective treatment for chronic radicular or discogenic low back pain.

Health Care and Indemnity Costs Across the Natural History of Disability in Occupational Low Back Pain

Spine ◽  
1998 ◽  
Vol 23 (21) ◽  
pp. 2329-2336 ◽  
Author(s):  
David A. Williams ◽  
Michael Feuerstein ◽  
David Durbin ◽  
John Pezzullo
Keyword(s):  
Health Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Natural History ◽  
Low Back ◽  
History Of ◽  
Occupational Low Back Pain
Sign in / Sign up

Export Citation Format

Share Document