No acceleration of intervertebral disc degeneration after a single injection of bupivacaine in young age group with follow-up of 5 years.
METHODS
Prospective study of changes in intervertebral disc degeneration after injection of bupivacaine.


OBJECTIVE
To examine whether injection of bupivacaine into human intervertebral discs accelerates their degeneration.


BACKGROUND
Bupivacaine is commonly used for therapy and diagnosis of discogenic low back pain. However, several in vitro studies have reported toxic effects of bupivacaine to disc cells. We sought to evaluate whether this finding is clinically relevant.


METHODS
We selected 46 patients with low back pain who showed disc degeneration at only one level (L4-L5 or L5-S1) on magnetic resonance imaging (MRI) (discography group, n=18), discoblock group (injection of bupivacaine, n=18), and a control group, n=10). There were no significant differences in baseline characteristics across the 3 groups. The two experimental groups underwent either discography or anesthetic discoblock, respectively. All three groups were followed up 5 years after the examination.


RESULTS
At 5 years follow-up, there was no significant difference in the rate of disc degeneration among the 3 groups (p>0.1). Moreover, X-ray images showed that there was no significant difference in disc height, range of motion, or translation between flex and extension position (p>0.1).


CONCLUSIONS
In conclusion, radiologic and MRI findings did not show acceleration of intervertebral disc degeneration at 5 years after a single injection of bupivacaine into human discs.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Seiji
S
Ohtori
Gen
G
Inoue
Sumihisa
S
Orita
Yawara
Y
Eguchi
Nobuyasu
N
Ochiai
Shunji
S
Kishida
Kazuki
K
Kuniyoshi
Junichi
J
Nakamura
Yasuchika
Y
Aoki
Tetsuhiro
T
Ishikawa
Masayuki
M
Miyagi
Hiroto
H
Kamoda
Miyako
M
Suzuki
Masashi
M
Takaso
Tomoaki
T
Toyone
Gou
G
Kubota
Yoshihiro
Y
Sakuma
Yasuhiro
Y
Oikawa
Kazuhide
K
Inage
Takeshi
T
Sainoh
Kazuhisa
K
Takahashi
Bupivacaine; Intervertebral disc degeneration; Lumbar vertebrae