Long-term efficacy of intradiscal steroids for low back syndromes

Author： Koning Henk M. Koning Alex J. Bruinen Tobias C.M. Koster Hans G.

ISSN： 1568-5691

Source： The Pain Clinic, Vol.13, Iss.2, 2001-06, pp. : 133-143

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Abstract

Background: Intradiscal steroid therapy can offer an additional therapeutic modality that may be beneficial for lumbar disc patients as an alternative to surgical intervention.Aims: Toevaluate the long-term efficacy of intradiscal steroid therapy and to identify factors that may enhance the long-term success of this procedure.Methods: A total of 85 consecutive patients were screened, who were treated in a oneyear period with intradiscal steroids for chronic low back pain and/or sciatica with normal neurological findings on examination. Patients considered as having clinical benefit from intradiscal steroid therapy and who did not experience a relapse of their complaints in the follow-up period were included for an assessment by questionnaire. An independent observer conducted a long-term follow-up assessment of the therapy by telephone interview.Results: Two months following intradiscal steroid therapy, 43 of the 85 patients reported an improvement. One year after intradiscal steroid therapy, continuing pain relief occurred in seventy-four percent of the successfully treated patients and it decreased to forty-four percent of the patients two years after treatment. Twenty-one per cent patients obtained a good long-term effect (2 years or more) from the intradiscal steroid injection. Female patients are expected to have a longer period of pain relief from intradiscal steroid therapy. No back pain and osteophyte formation present at level L4-L5 were significant predictors of a good long-term outcome.Conclusions: Intradiscal steroid therapy can be a useful alternative for patients with low back syndromes not responding to conventional therapy.