Turkish Journal of Physical Medicine and Rehabilitation 2012 , Vol 58 , Num 2

The Efficacy of Intradiscal Steroid Injections in Degenerative Lumbar Disc Disease

Ferdi Yavuz 1 ,M. Ali Taşkaynatan 2 ,Koray Aydemir 3 ,Ahmet Özgül 4 ,Arif Kenan Tan 2
1 Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Gülhane Military Medical Academy, Ankara, Turkey
2 Gülhane Askeri Tıp Akademisi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
3 Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
4 GATA Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara
DOI : 10.4274/tftr.33602

Objective: We aimed to investigate the efficacy of intradiscal steroid injection in patients with chronic low back pain due to degenerative disc disease.

 

Materials and Methods: A total of 18 patients (9 female, 9 male) with chronic low back pain of discogenic origin were enrolled in the study. The intervertebral disc level which met the diagnostic criteria for provocative discography was defined as discogenic pain level. After identification of positive disc level, 1 cc betamethasone was injected into the disc. The outcome measures (visual analog pain scale and Quebec Back Pain Disability Scale scores, finger-tip-to-floor distance and duration of sitting without pain) were assessed before the treatment and at second week and third month post injection.

 

Results: The reduction in low back pain intensity between the baseline and second week, and between the baseline and third month was statistically significant (p=0.001 and p=0.002). Besides, statistically significant improvement was observed in Quebec Disability Scores between the baseline and second week, and between the baseline and third month (p=0.001 and p=0.002). The finger-tip-to-floor distance between the baseline and second week, and between the baseline and third month showed a statistically significant improvement (p=0.002 and p=0.02). The duration of sitting without pain between the baseline and second week, and between the baseline and third month showed a statistically significant increase (p=0.001 and p=0.009).

 

Conclusion: As a result, we suggest that intradiscal steroid injection may be effective in short-term and mid-term for reducing the intensity of spinal pain and the proportion of disability due to chronic discogenic low back pain in patients who do not respond to conservative treatment. 

Keywords : Degenerative disc disease, discogenic low back pain, discography, intradiscal injection, corticosteroid