Journal List > J Korean Soc Spine Surg > v.12(1) > 1035691

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Kim, Kang, Park, Na, Kim, Ahn, Lee, and Choy: Availability of Intradiscal Injection of Marcaine as a Pain Relief Test for Diagnosis of Internal Disc Disruption
Original Article

Journal of Korean Spine Surg 2005;12(1):45-51.

Published online: 21 February 2005

DOI: https://doi.org/10.4184/jkss.2005.12.1.45

Availability of Intradiscal Injection of Marcaine as a Pain Relief Test for Diagnosis of Internal Disc Disruption

Whoan Jeang Kim, M.D., Jong Won Kang, M.D., Jae Guk Park, M.D., Kyu Hyun Na, M.D., Ha Yong Kim, M.D., Jae Hoon Ahn, M.D., Kwang Won Lee, M.D., Won Sik Choy, M.D.

Department of Orthopaedic Surgery, Eulji University School of Medicine

Address reprint requests to Whoan Jeang Kim, M.D. Department of Orthopaedic Surgery, Eulji University School of Medicine,1306, Dunsan-dong, Seo-gu, Daejon, 302-799, Korea Tel: 82-42-611-3267, Fax: 82-42-259-1289, E-mail: hjkim@eulji.ac.kr

Copyright © 2005 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A retrospective study

Objectives

To investigate the availability of an intradiscal injection of marcaine as a pain relief test to enhance specificity in the diagnosis of IDD.

Summary of Literature Review

The diagnosis and treatment of IDD have been controversial. A discography, which has been widely used for the diagnosis of IDD, has many problems that might result in a faulty diagnosis.

Materials and Methods

Twenty nine patients, with an average age and duration of symptom of 36.9 years (22 to 46 years) and 5 years 1month (6 months to 10 years), respectively, were reviewed. A fter the discography, the marcaine was injected. Based on the responses after the injection, the group was sub- divided into a further two groups.
Group A (n=19): transient pain relief and surgical treatment was performed.
Group B (n=10): no pain relief and conservative treatment was performed. A n analysis to examine the correlation between the response to marcaine and age, duration of symptom, subjective pain level, number of disc degeneration and high intensity zone was also performed, and the clinical results quantified.

Results

The agreement rate between the discography and response to marcaine was 55.2%. The longer the symptom duration, the more meaningful were the responses to the marcaine injection (p<0.05). The result of surgical treatment was important statistically, as the pain was relieved from 8.6± 0.97 to 1.8± 0.42 points, and the ODI decreased from 68± 16.92 to 30± 9.97%(p<0.05).

Conclusions

A n intradiscal injection of marcaine, as the pain relief test, can enhance the specificity for the diagnosis of IDD.

Keywords: IDD, Pain relief test, Intradiscal injection of marcaine

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Table 1.
Correlations between age and response of marcaine
age Group A Group B Total
-30 3 3 6
31-35 2 3 5
36-40 3 3 6
41- 8 4 12

* Group A : Marcaine(+), Group B : Marcaine(-) (p>0.05)

Table 2.
Correlations between duration of symptom and response of marcaine
Duration of Sx Group A Group B Total
Below 2 years 4 7 11
2-5 years 3 3 6
Above 5 years 9 2 11

* Group A : Marcaine(+), Group B : Marcaine(-)(p<0.05)

Table 3.
Correlations between subjective pain and response of marcaine
10 point pain scale Group A Group B Total
7 4 4 8
8 4 4 8
9 5 3 8
10 3 2 5

* Group A : Marcaine(+), Group B : Marcaine(-) (p>0.05)

Table 4.
Correlations between No. of degenerative disc and response of marcaine
degenerative disc Group A Group B Total
1 segment 6 7 13
2 segments 5 3 8
3 segments 3 2 5
4 segments 2 1 3

* Group A : Marcaine(+), Group B : Marcaine(-)(p>0.05)

Table 5.
Correlations between HIZ and response of marcaine
Group A Group B Total
HIZ (+) 3 8 11
HIZ (-) 13 5 18

* Group A : Marcaine(+), Group B : Marcaine(-)* HIZ = High-intensity zone (p>0.05)

Table 6.
Outcomes of treatment results in Group A1
Preop. Last F/U
10-point pain scale 8.6± 0.97 1.8± 0.42%.
ODI 68± 16.92% 30± 9.97%

* ODI : Oswestry Disability Index (p<0.05)

Table 7.
Outcomes of treatment results in group B1
Initial Last F/U
10-point pain scale 8.3± 1.5800 4.9± 2.5300
ODI 59.4± 19.48% 29.4± 22.56%

* ODI : Oswestry Disability Index (p>0.05)

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