Clinical Observation Of Discography Methylene Blue Injection In The Treatment Of Discogenic Low Back Pain

Objectives:To investigate the efficacy of the intradiscal methylene blue injection for the treatment of discogenic low back pain and try to find some new evidence.Methods:This study evaluates the pain relief and functional improvement in a total of 31 patients treated with methylene blue injection at pre- and post-treatment(1,3,6,12 months). The degree of low back pain and lumbar function were compared by visual analog scale(VAS) and Oswestry disability index(ODI) at pre- and post-treatment(1,3,6,12 months).Disc degeneration changes were compared by apparent diffusion coefficient and T2 relax time at pre- and post-treatment(3,6,12 months). All patients got a follow-up period up to 12 months.Results:The mean Numeric Rating Scale scores at pre-and post-treatment (1,3,6,12 months) were 6.68,3.21,3.36,4.07 and 4.95 respectively. There was a minimum of 2 points reduction at 1,3 and 6 months after the treatment, but less than 2 points reduction at 12 months. There was at least 50% improvement on Oswestry Disability Index at 1,3 and 6 months after the treatment except for the time of 12 months. Besides, the apparent diffusion coefficient and T2 relax time increased after the treatment and there was no significant difference between pre-and post-treatment(3,6 months), and significant difference was found between pre-treatment and 12 months after treatment.Conclusions:The intradiscal methylene blue injection might be an effective therapy for discogenic low back pain for short-term, but not for long-term. Besides, the improvement of disc degeneration condition is not clear. Further studies with a larger sample size and longer follow-up period might be necessary.