Comparison of Four Different Analgesic Discogram Protocols Comparing the Incidence of Reported Pain Relief Following Local Anesthetic Injection into Concordantly Painful Lumbar Intervertebral Discs

Derby, Richard; Aprill, Charles; Lee, Jeong Eun; DePalma, Michael J.; Baker, Russell T.

doi:10.1111/j.1526-4637.2012.01499.x

Cited by 21 publications

(13 citation statements)

References 26 publications

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“…Reports of exposing articular chondrocytes cultures at higher concentrations of lidocaine (1 to 2%) demonstrated cell death [12, 15]. In some spine clinics, 4% lidocaine is injected after a provocation discography [2]. At this high concentration of lidocaine, we would expect to see more cell death.…”

Section: Discussionmentioning

confidence: 99%

“…Some discography procedures include the use of anesthetics. These may be mixed directly with the contrast agent [2, 3], injected alone without contrast media [2], or may be added after a traditional provocation discography with or without the use of an intradiscal catheter for functional testing [2, 4-6]. It is under investigation if using anesthetic in discography procedures will decrease the false positive rate of conventional provocation discography [2-6].…”

Section: Introductionmentioning

confidence: 99%

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Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system

et al. 2014

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“…They exclude those with pain resulting from purely nonspecific or myofascial causes and include those with the commonly presenting mixed syndrome of low back pain with underlying disc pathology and possibly spinal stenosis or facet disease, and no sensory or motor deficits. Studies indicate that 40% of all cLBP may be discogenic in nature[23]. …”

Section: Methodsmentioning

confidence: 99%

Phenotype Matters

Dolman¹,

Loggia

Edwards

et al. 2014

The Clinical Journal of Pain

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Studies have associated chronic low back pain (cLBP) with grey matter thinning. But these studies have not controlled for important clinical variables (such as a comorbid affective disorder, pain medication, age, or pain phenotype), which may reduce or eliminate these associations. We conducted cortical thickness and voxel-based morphometry (VBM) analyses in 14 cLBP patients with a discogenic component to their pain, not taking opioids or benzodiazepines, and not depressed or anxious. They were age and gender matched to 14 healthy controls (HCs). An ROI-driven analysis (regions of interest) was conducted, using 18 clusters from a previous arterial spin labeling study demonstrating greater regional cerebral blood flow (rCBF) in these cLBP subjects than the HCs. Cortical thickness and VBM-based gray matter volume measurements were obtained from a structural MRI scan and group contrasts were calculated. MANOVA showed a trend toward cortical thickening in the right paracentral lobule in cLBP subjects (F(1,17)=3.667, p<0.067), and significant thickening in the right rostral middle frontal gyrus (F(1,17)=6.880, p<0.014). These clusters were non-significant after including age as a covariate (p<0.891; p<0.279). A whole-brain cortical thickness and VBM analysis also did not identify significant clusters of thinning or thickening. Exploratory analyses identified group differences for correlations between age and cortical thickness of the right rostral middle frontal gyrus (cLBP: R=-0.03, p=0.9; HCs: R=-0.81, p<0.001), i.e., HCs demonstrated age-related thinning while cLBP patients did not. Our pilot results suggest that controlling for affect, age, and concurrent medications may reduce or eliminate some of the previously reported structural brain alterations in cLBP.

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“…58,59 CAs, along with local anesthetics, 60 have been shown to be cytotoxic to intervertebral disc cells (IVDCs) in in vitro studies. 61 CAs have shown to be less cytotoxic to IVDCs than local anesthetics are; and iopamidol showed to be more toxic to IVDCs than iohexol did.…”

Section: Cytotoxicity Of Casmentioning

confidence: 99%

Contrast agents used in interventional pain: Management, complications, and troubleshooting

Ares

Amatriaín

Iglesias

et al. 2014

Techniques in Regional Anesthesia and Pain Management

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Comparison of Four Different Analgesic Discogram Protocols Comparing the Incidence of Reported Pain Relief Following Local Anesthetic Injection into Concordantly Painful Lumbar Intervertebral Discs

Abstract: If the criterion standard to confirm painful annular tears is concordant pain provocation and 80% or greater pain relief following LA injected into lumbar discs, the SAAD, ADPD, and FAD protocols show statistically similar 20% to 30% prevelance.

Cited by 21 publications

References 26 publications

Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system

Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system

Phenotype Matters

Contrast agents used in interventional pain: Management, complications, and troubleshooting

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