Objective To determine the therapeutic effects of intradiscal steroid injection in patients with lumbar discogenic pain. Method Seventeen patients with lumbar discogenic pain who have not received other interventional procedures were studied. After confirmation of needle placement into the discs by C-arm fluoroscopy, discogram was done. And 40 mg of triamcinolone and 0.5 cc of 2% lidocaine were injected into the nucleus. Correlation between degeneration and Visual Analogue Scale (VAS) was analyzed. The effects of steroid injection were evaluated using VAS and limitation of lumbar flexion at pre-injection, 1 week post-injection, 1 month post-injection, and 3 months post-injection. Changes over time were assessed statistically using ANOVA and chisquare.
Results Correlation between degeneration and VAS was high (r=0.7). The averages of VAS reduced significantly from 6.1⁑1.6 at pre-injection, to 2.4⁑1.8 at 1 week post- injection, to 1.8⁑1.2 at 3 months post-injection, respectively (p<0.05). The number of group of highly or moderately limited lumbar flexion was decreased from 10 at pre- injection to 4 at 1 day post-injection. Fourteen of 17 patients (82.4%) had a successful outcome reporting at least 50% reduction between pre and 3 months post-injection in VAS.
Conclusion Intradiscal steroid injection was an effective treatment for patients with lumbar discogenic pain. (J Korean Acad Rehab Med 2003; 27: 240-244)
|