Objective: To understand the natural history and prognosis of patients with discogenic low back pain so as to offer a better guide on its clinical treatment.
Methods: From December 2003 to November 2004, we consecutively hospitalized 72 patients with discogenic low back pain diagnosed by lumbar discography. These patients were randomized into two groups. One group (n = 36) received an intradiscal methylene blue (MB) injection immediately after discography while another group (n = 36) received a placebo. Both Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were used to assess the back pain symptoms and the lumbar function respectively during a 4-year follow-up period.
Results: In total, 32 of 36 patients who received a placebo injection underwent a 4-year follow-up. Of these patients, 4 cases (12.5%) had their low back pain symptoms alleviated, 1 case (3.1%) slightly improved, 3 cases (9.4%) aggravated and 22 cases (68.8%) had no change in symptoms. According to VAS and ODI scores taken at different time points, these two scores gradually decreased over time; however, no statistical significances were found (VAS: F = 3.049, P > 0.05; ODI: F = 2. 272, P > 0.05).
Conclusion: The disease course of discogenic low back pain is chronic and persistent so that its symptoms show no improvement over time.
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World J Orthop
January 2025
Department of Orthopedics, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing 100039, China.
Lumbar intervertebral disc degeneration is thought to be the main cause of low back pain, although the mechanisms by which it occurs and leads to pain remain unclear. In healthy adult discs, vessels and nerves are present only in the outer layer of the annulus fibrosus and in the bony endplate. Animal models, and histological and biomechanical studies have shown that annulus tear or endplate injury is the initiating factor for painful disc degeneration.
View Article and Find Full Text PDFWorld J Orthop
January 2025
Department of Orthopeadics, Featured Medical Center of Chinese People's Armed Police Forces, Tianjin 300000, China.
In healthy intervertebral discs (IVDs), nerves and blood vessels are present only in the outer annulus fibrosus, while in degenerative IVDs, a large amount of nerve and blood vessel tissue grows inward. Evidence supports that neurogenic inflammation produced by neuropeptides such as substance P and calcitonin gene related peptide released by the nociceptive nerve fibers innervating the IVDs plays a crucial role in the process of IVD degeneration. Recently, non-neuronal cells, including IVD cells and infiltrating immune cells, have emerged as important players in neurogenic inflammation.
View Article and Find Full Text PDFNeurosciences (Riyadh)
January 2025
From the Department of Algology (Göksu), Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, from the Department of Algology (Celik, Akcaboy, Şahin), University of Health Sciences Ankara City Hospital, Ankara, from Ankara Gaziler PMR Training and Research Hospital (Baran), University of Health Sciences, Ağrı, from the Department of Algology (Yıldız), University of Health Sciences Ankara Etlik City Hospital, Ankara, from the Department of Algology (Kaya), Adıyaman University Training and Research Hospital, Adıyaman, and from the Department of Algology (Ayhan), Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital, Kütahya, Turkey.
Objectives: To compare the effectiveness of preganglionic transforaminal epidural steroid injection (TFESI) with preganglionic plus postganglionic TFESI.
Methods: Patients with unilateral radicular pain and disc pathology were randomly assigned to either the preganglionic group or the preganglionic plus postganglionic group. All patients were evaluated using a numeric rating scale (NRS) and a patient satisfaction scale (PSS) at the third week and the third month after treatment.
Int J Spine Surg
January 2025
Spine Consultant, Department of Orthopedic and Traumatology, Mayapada Hospital Kuningan, Jakarta, Indonesia.
Background: Low back pain (LBP) is 1 of the most common problems that present in 80% of people. LBP can be caused by some pathologies, with discogenic pain being 1 source. Pain from LBP can become chronic and also cause disability.
View Article and Find Full Text PDFJOR Spine
December 2024
Trinity Centre for Biomedical Engineering Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin Dublin Ireland.
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