title: Single Intradiscal Administration of the Tumor Necrosis Factor-Alpha Inhibitor, Etanercept, for Patients with Discogenic Low Back Pain.
abstract: OBJECTIVE
  To examine the analgesic effect of intradiscal administration of a tumor necrosis factor-αα (TNF-α) inhibitor in patients with discogenic low back pain (LBP).
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Department of Orthopaedic Surgery, Chiba (Japan) University Hospital.
  
  
  METHODS
  Seventy-seven patients diagnosed with discogenic LBP.
  
  
  METHODS
  Discogenic LBP patients were randomly assigned to the etanercept (n = 38; bupivacaine [2 mL] with etanercept [10 mg]) or control (n = 39; bupivacaine [2 mL]) groups. Patients received a single intradiscal injection. Numerical rating scale (NRS) scores for LBP at baseline, 1 day, and 1, 2, 4, and 8 weeks after the injection were recorded. The Oswestry disability index (ODI) scores at baseline and at 4 and 8 weeks after injection were evaluated. Postinjection complications were recorded and evaluated.
  
  
  RESULTS
  In the etanercept group, the NRS scores were significantly lower than in the control group at every time point after the injection for 8 weeks (P < 0.05). Similarly, 4 weeks after the injection, the ODI score was lower in the etanercept group than in the control group (P < 0.05). However, the ODI scores were not significantly different at 8 weeks. Complications were not observed.
  
  
  CONCLUSIONS
  Single intradiscal administration of a TNF-α inhibitor can alleviate intractable discogenic LBP for up to 8 weeks. TNF-α may be involved in discogenic pain pathogenesis. This procedure is a novel potential treatment; longer-term effectiveness trials are required in the future.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sainoh
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kamoda
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzuki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Go
authors.initials: G
authors.lastname: Kubota
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Inage
authors.forename: Jun
authors.initials: J
authors.lastname: Sato
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakata
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000068800:Etanercept / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000188:drug therapy; D007564:Japan; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept