Discogenic Back Pain
Conditions
Keywords
Back pain, Discogel
Brief summary
Discogenic low back pain is the most common form of chronic low back pain. Its diagnosis is mainly based on MR imaging, showing MODIC I or II changes in patients with concordant symptomatology. The treatment of discogenic low back pain is nevertheless difficult: intradiscal therapies (corticosteroids, methylene blue, radiofrequency) have a limited efficacy, and surgical procedures (arthrodesis or disc replacement) are a final recourse with notable risk of side-effects. In this study, the efficacy of intradiscal injection of gelified ethanol (DiscoGel) in patients with disabling discogenic pain is assessed.
Interventions
DiscoGel is a sterile viscous solution containing ethyl alcohol, cellulose derivative product and tungsten (radio-opaque element)
Conventional treatment based on current guidelines regarding the management of discogenic low back pain, including but not limited to: * medications (analgesics, NSAIDs, muscle relaxants), * physical therapy, * manual techniques, * transcutaneous electrical nerve stimulation (TENS), * blocks
Sponsors
Study design
Eligibility
Inclusion criteria
* MR imaging : MODIC 1or MODIC 2 changes limited to one single lumbar disc; * X rays: normal disc height, no instability; * Back pain for at least 3 months, without argument for another etiology; * Mean pain on 5 days VAS ≥ 5
Exclusion criteria
* age \<18 years or \> 50 ; concomitant radicular pain ; * psychiatric pathology that may modify the perception or the evolution of pain; * MR imaging: multi-level discopathy, MODIC 3 changes; * X ray: loss of disc height \> 50%, segmental instability; * previous history of lumbar surgery with or without instrumentation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) | Six months after the procedure. | Mean pain intensity score on a Visual Analog Scale (VAS), six months after the procedure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS), | one month, three months, six months and 1 year after the procedure | Mean pain intensity score on Visual Analog Scale (VAS), one month, three months, six months and 1 year after the procedure ; |
| Oswestry Disability Index (ODI) | one month, three months, six months and 1 year after the procedure | Oswestry Disability Index (ODI) one month, three months, six months and 1 year after the procedure ; |
| Euroqol score | month, three months, six months and 1 year after the procedure | Assessment of the quality of life with Euroqol score (EQ-5D) one month, three months, six months and 1 year after the procedure |
Countries
France