Abstract
Purpose
The purpose of this study was to evaluate the efficacy of sinuvertebral nerve blocks in the diagnosis of discogenic low back pain.
Patients and methods
In this retrospective cohort study, the data of 48 patients with high clinical suspicion of discogenic low back pain from L4/5 who received nerve block treatment from 2017 to 2018 were collected. Twenty-four patients received discoblock (L4/5 intradiscal injection of 1 ml 0.5% lidocaine) and another 24 patients received the sinuvertebral nerve block(L4/5 intervertebral space injection of 0.5 ml 0.5% lidocaine bilaterally). Percutaneous endoscopic radiofrequency thermal annuloplasty was performed in patients who responded to the diagnostic block. The visual analogue scale scores and Oswestry Disability Index scores in both groups before and 1, 3, and 12 months after surgery were compared.
Results
Ten patients with a negative diagnostic block did not undergo surgery. Eighteen patients in the discoblock group and 20 patients in the sinuvertebral nerve block group showed a positive response and were evaluated. There were no differences in visual analogue scale or Oswestry Disability Index scores between the two cohorts at baseline or at all time points postsurgery (all p > 0.05). When comparing baseline values to all time points postsurgery improved visual analogue scale scores, and Oswestry Disability Index scores were observed within both cohorts (all p < 0.05).
Conclusion
The effect of sinuvertebral nerve block as a diagnostic tool for discogenic low back pain is similar to that of discoblock, and it is a promising tool that deserves further study.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
References
Pan F, Shen B, Chy SK et al (2016) Transforaminal endoscopic system technique for discogenic low back pain: a prospective Cohort study. Int J Surg 35:134–138
Kallewaard JW, Terheggen MA, Groen GJ et al (2010) 15. Discogenic low back pain. Pain Pract 10:560–579
Crock HV (1986) Internal disc disruption A challenge to disc prolapse fifty years on. Spine (Phila Pa 1976) 11:650–653
Zhao Q, Cheng L, Yan H et al (2020) The anatomical study and clinical significance of the sinuvertebral nerves at the lumbar levels. Spine (Phila Pa 1976) 45:E61–E66
Schwarzer AC, Aprill CN, Derby R et al (1995) The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 20:1878–1883
Geurts JW, Willems PC, Kallewaard J-W et al (2018) The impact of chronic discogenic low back pain: costs and patients’ burden. Pain Res Manag 2018:4696180
Maher C, Underwood M, Buchbinder R (2017) Non-specific low back pain. Lancet 389:736–747
Walsh TR, Weinstein JN, Spratt KF et al (1990) Lumbar discography in normal subjects. A controlled, prospective study. J Bone Joint Surg Am 72:1081–1088
Fukui S, Nitta K, Iwashita N et al (2013) Intradiscal pulsed radiofrequency for chronic lumbar discogenic low back pain: a one year prospective outcome study using discoblock for diagnosis. Pain Physician 16:E435–E442
Carragee EJ, Don AS, Hurwitz EL et al (2009) 2009 ISSLS Prize Winner: does discography cause accelerated progression of degeneration changes in the lumbar disc: a 10-year matched cohort study. Spine 34:2338–2345
Cuellar JM, Stauff MP, Herzog RJ et al (2016) Does provocative discography cause clinically important injury to the lumbar intervertebral disc? A 10-year matched cohort study. Spine J 16:273–280
Chee AV, Ren J, Lenart BA et al (2014) Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system. Spine J 14:491–498
Raoul S, Faure A, Robert R et al (2003) Role of the sinu-vertebral nerve in low back pain and anatomical basis of therapeutic implications. Surg Radiol Anat 24:366–371
McNally DS, Naish C, Halliwell M (2000) Intervertebral disc structure: observation by a novel use of ultrasound imaging. Ultrasound Med Biol 26:751–758
Schliessbach J, Siegenthaler A, Heini P et al (2010) Blockade of the sinuvertebral nerve for the diagnosis of lumbar diskogenic pain: an exploratory study. Anesth Analg 111:204–206
Pfirrmann CW, Metzdorf A, Zanetti M et al (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976) 26:1873–1878
Weishaupt D, Zanetti M, Boos N et al (1999) MR imaging and CT in osteoarthritis of the lumbar facet joints. Skeletal Radiol 28:215–219
Goutallier D, Postel JM, Bernageau J et al (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83
Meyerding HW (1941) Low backache and sciatic pain associated with spondylolisthesis and protruded intervertebral disc: incidence. Significance, And Treatment 23:461–470
Park JW, Nam HS, Cho SK et al (2011) Kambin’s triangle approach of lumbar transforaminal epidural injection with spinal stenosis. Ann Rehabil Med 35:833–843
Ohtori S, Kinoshita T, Yamashita M et al (2009) Results of surgery for discogenic low back pain: a randomized study using discography versus discoblock for diagnosis. Spine 34:1345–1348
Putzier M, Streitparth F, Hartwig T et al (2013) Can discoblock replace discography for identifying painful degenerated discs? Eur J Radiol 82:1463–1470
Kotilainen E, Muittari P, Kirvela O (1997) Intradiscal glycerol or bupivacaine in the treatment of low back pain. Acta Neurochir (Wien) 139:541–545
Gruber HE, Rhyne AL 3rd, Hansen KJ et al (2012) Deleterious effects of discography radiocontrast solution on human annulus cell in vitro: changes in cell viability, proliferation, and apoptosis in exposed cells. Spine J 12:329–335
Bogduk N, Tynan W, Wilson AS (1981) The nerve supply to the human lumbar intervertebral discs. J Anat 132:39–56
Acknowledgements
The authors would like to acknowledge the patients who agreed to participate in this study.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors have no conflicts of interest to report.
Ethics approval
The Chinese Ethics Committee of Registering Clinical Trials (ChiECRCT20210549, 22 December, 2021) approved all methods, and all work was carried out in accordance with the Declaration of Helsinki.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Wang, G., Zhang, Z., Liu, J. et al. Comparison of the effect of diagnosing discogenic low back pain by sinuvertebral nerve block versus discoblock a retrospective cohort study. Eur Spine J 32, 2093–2100 (2023). https://doi.org/10.1007/s00586-023-07732-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-023-07732-2