[Intradiscal injection of acetate of prednisolone in severe low back pain: complications and patients' assessment of effectiveness].
OBJECTIVE
To investigate complications (calcification and/or disc collapse) as seen on radiography and patient-assessed effectiveness after intradiscal injections of acetate of prednisolone (Hydrocortancyl).


METHODS
A retrospective study of medical records of 67 patients (68 injected discs) given an intradiscal injection of acetate of prednisolone for low back pain with endplate signal changes on magnetic resonance imaging and/or evidence of fast destructive discopathy, as well as records of 85 patients (55 women, mean age 49 +/-9 years) to assess the effectiveness of intradiscal injection: the global appreciation of the patient (excellent, good, mild, none, worse) concerning the result of the intradiscal injection at one, three and six months. Two physicians were blinded during analysis of images.


RESULTS
The mean period of follow up for radiographics was 10.25 +/-5.99 months. A total of 44.8% of the patients had control at six months and 38.8% at 12 months or more. No calcification was found, but two discs showed a collapse of 20 and 25% at six and 12 months, respectively, after the injection. For effectiveness of intradiscal injection, 71.8% the patients considered the result good or excellent at one month, 55.3% at three months and 43.5 % at six months.


CONCLUSIONS
The benefit-to-risk ratio of use of acetate of prednisolone intradiscal injection seems good in selected patients with low back pain.
Benyahya
R
R
Service de rééducation et de réadaptation de l'appareil locomoteur et des pathologies du rachis, hôpital Cochin, université René-Descartes, assistance Publique-Hôpitaux de Paris, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.
Lefevre-Colau
M-M
MM
Fayad
F
F
Rannou
F
F
Demaille-Wlodyka
S
S
Mayoux-Benhamou
M-A
MA
Poiraudeau
S
S
Revel
M
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002114:Calcinosis; D005260:Female; D006801:Humans; D007403:Intervertebral Disc; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000188:drug therapy*; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011239:Prednisolone