Jean-Luc Drape MD,PhD, Presenter: Nothing to Disclose

Fouad Fayad MD, Abstract Co-Author: Nothing to Disclose

Antoine Feydy MD, PhD, Abstract Co-Author: Nothing to Disclose

Henri Guerini MD, Abstract Co-Author: Nothing to Disclose

Michel Revel, Abstract Co-Author: Nothing to Disclose

Alain Chevrot MD, Abstract Co-Author: Nothing to Disclose

To assess the clinical response to intradiscal steroid injections in inflammatory degenerative disc disease

Inclusion criteriae were: severe low back pain resistant to medical treatment with associated bone marrow edema of the vertebral end-plates (Modic 1). Inclusion of 74 patients shared according to MRI findings between pure Modic 1 (group 1, n=37), mixed Modic with predominant edema (group 2, n=25), mixed Modic with fatty predominance (group 3, n=12). Intradiscal injection of 25 mg of prednisolone acetate at L5-S1 (n=33), L4-L5 (n=30), L3-L4 (n=5) and L2-L3 (n=6) levels. All patients were clinically assessed (low back pain AVS, disability AVS, Quebec Questionnaire, finger-to-floor test, modified Schober test, patient satisfaction) before the procedure, at the end of the hospitalization, at 1 month, 3 months and 6 months.

The results were considered as good or excellent with 50% or more improvement of low back pain AVS at the end of hospitalization (67% group 1, 60% group 2, 42% group3), at 1 month (49% group 1, 52% group 2, 8% group 3), 3 months (30% group 1, 28% group 2, 8% group 3) and 6 months (22% group 1, 16% group 2, 16% group 3). At the end of hospitalization, the AVS delta was not significantly different between the 3 groups, but significantly higher at 1 month for groups 1 and 2 (p=0.017) (Kruskal-Wallis test). At 1 month patient satisfaction was good or excellent in 49% group 1, 32% group 2 and 16% group 3.

The efficiency of steroid intradiscal injection on low back pain is significantly higher in case of pure or predominant Modic 1 changes associated with the degenerative disc disease during the month following the procedure. This injection stamps out an acute onset on a background of chronic low back pain.

Intradiscal steroid injection can stamp out a subacute low back pain fit in degenerative disc disease with associated pure or predominant Modic 1 changes.

Drape, J, Fayad, F, Feydy, A, Guerini, H, Revel, M, Chevrot, A, Inflammatory Degenerative Disc Disease: Assessment of Efficiency of Intradiscal Steroid Injections.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4431558.html