Diagnostic and therapeutic value of intradiscal steroid injection in patients with discogenic low back pain combined with radial fissure of annulus fibrosis / 中华骨科杂志

ABSTRACT

Objective To retrospectively investigate diagnostic and therapeutic value of intradiscal steroid injection in patients with discogenic low back pain combined with radial fissure of annulus fibrosis.Methods Totally 120 patients who had undergone CT guided intervertebral discography and steroid injections,including 72 males and 48 females,aged from 25 to 60 years (average,48 years),were recruited to this study.According to Dallas discography description system,7 cases were rated as grade 0,36 grade 1,48grade 2,and 29 grade 3.The Visual Analogue Scale (VAS) and Roland Morris Disability Questionnaire (RMDQ) were used to evaluate clinical effect at 2 weeks,2 months,6 months,12 months and 24 months postoperatively.Results Most of patients who underwent steroid injection in single highly suspect diseased disc claimed significant symptom improvement.There were statistically significant differences between pre- and post-operative VAS and RMDQ.The clinical effect in grade 3 group was better than those in grade 1 and grade 2 groups,and the differences were significant.Patients with severe disc disruption (grade 3) had a lower recurrence rate of low back pain compared with other patients.Conclusion Intradiseal steroid injection not only can significantly relieve discogenic low back pain,but also can benefit diagnosis of discogenic low back pain,especially in patients who fail to reproduce concordant pain on discography.For patients with severe rupture of the annulus fibrosus,the relief of discogenic low back pain is more significant.