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Discoblock Effective for Back Pain Diagnosis

Patients who experience pain relief after discoblock have better outcomes after surgery

MONDAY, June 15 (HealthDay News) -- Pain relief after an injection of bupivacaine rather than pain provocation after injection of contrast medium into the painful disc is a useful tool to diagnose discogenic lower back pain, and patients have better outcomes after spinal surgery, according to a study in the June 1 issue of Spine.

Seiji Ohtori, M.D., and colleagues from Chiba University in Japan randomly assigned 42 patients with severe lower back pain and lumbosacral disc degeneration to discography (injection of contrast medium into disc) or discoblock (injection of bupivacaine into disc) to diagnose discogenic lower back pain. Anterior discectomy and interbody fusion were performed in the 15 discography patients who responded by pain provocation and the 15 discoblock patients who responded by pain relief.

Three years after surgery, the researchers found that the discoblock group had more improvement in the visual analogue scale score, Japanese Orthopedic Association Score, and Oswestry Disability Index score. Only one discoblock patient was dissatisfied with surgery compared with three discography patients.

"Pain relief after injection of a small amount of bupivacaine into the painful disc was a useful tool for the diagnosis of discogenic lower back pain compared with discography," Ohtori and colleagues conclude.

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