ABSTRACT
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.
