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Intradiskal Treatments for Active Degenerative Disk Disease.

Abstract

Intradiskal steroid injections were first used 70 years ago. The initial failure of this treatment method can be ascribed to the absence of preclinical studies and of well-defined criteria for patient selection. Intradiskal calcifications were reported after triamcinolone hexacetonide or cortivazol injections, and proof of clinical benefits remained elusive. The concept of active degenerative disk disease (DDD) then emerged, and cases of incapacitating chronic low back pain with Modic I endplate changes were reported, leading to renewed interest in evaluating intradiskcal steroid injections. Prednisolone acetate was proven effective in providing short-term relief and was well tolerated in patients with incapacitating chronic low back pain and Modic I changes. This development highlights the importance of concomitant advances in identifying diagnostic entities and developing treatment strategies for patients with nonspecific low back pain.

Authors+Show Affiliations

Services de Rhumatologie, Médecine Physique et de Réadaptation, Hôpital Lariboisière-Fernand-Widal, AP-HP, Université de Paris, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: johann.beaudreuil@lrb.aphp.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31276821

Citation

Beaudreuil, Johann. "Intradiskal Treatments for Active Degenerative Disk Disease." Joint, Bone, Spine : Revue Du Rhumatisme, 2019.
Beaudreuil J. Intradiskal Treatments for Active Degenerative Disk Disease. Joint Bone Spine. 2019.
Beaudreuil, J. (2019). Intradiskal Treatments for Active Degenerative Disk Disease. Joint, Bone, Spine : Revue Du Rhumatisme, doi:10.1016/j.jbspin.2019.06.008.
Beaudreuil J. Intradiskal Treatments for Active Degenerative Disk Disease. Joint Bone Spine. 2019 Jul 2; PubMed PMID: 31276821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intradiskal Treatments for Active Degenerative Disk Disease. A1 - Beaudreuil,Johann, Y1 - 2019/07/02/ PY - 2019/06/12/accepted PY - 2019/7/6/pubmed PY - 2019/7/6/medline PY - 2019/7/6/entrez KW - Active degenerative disk disease KW - Intradiskal injections KW - Low back pain KW - Modic I JF - Joint, bone, spine : revue du rhumatisme JO - Joint Bone Spine N2 - Intradiskal steroid injections were first used 70 years ago. The initial failure of this treatment method can be ascribed to the absence of preclinical studies and of well-defined criteria for patient selection. Intradiskal calcifications were reported after triamcinolone hexacetonide or cortivazol injections, and proof of clinical benefits remained elusive. The concept of active degenerative disk disease (DDD) then emerged, and cases of incapacitating chronic low back pain with Modic I endplate changes were reported, leading to renewed interest in evaluating intradiskcal steroid injections. Prednisolone acetate was proven effective in providing short-term relief and was well tolerated in patients with incapacitating chronic low back pain and Modic I changes. This development highlights the importance of concomitant advances in identifying diagnostic entities and developing treatment strategies for patients with nonspecific low back pain. SN - 1778-7254 UR - https://www.unboundmedicine.com/medline/citation/31276821/Intradiskal_Treatments_for_Active_Disk_Disease L2 - https://linkinghub.elsevier.com/retrieve/pii/S1297-319X(19)30100-9 DB - PRIME DP - Unbound Medicine ER -