Asian Spine J.  2013 Sep;7(3):212-217. 10.4184/asj.2013.7.3.212.

No Acceleration of Intervertebral Disc Degeneration after a Single Injection of Bupivacaine in Young Age Group with Follow-Up of 5 Years

• Ohtori S
• Inoue G
• Orita S
• Eguchi Y
• Ochiai N
• Kishida S
• Kuniyoshi
• Nakamura J
• Aoki Y
• Ishikawa T
• Miyagi M
• Kamoda H
• Suzuki M
• Takaso M
• Toyone T
• Kubota G
• Sakuma Y
• Oikawa Y
• Inage K
• Sainoh T
• Takahashi

• KMID: 2270434
• DOI: http://doi.org/10.4184/asj.2013.7.3.212

Abstract

STUDY DESIGN: Prospective study of changes in intervertebral disc degeneration after injection of bupivacaine. PURPOSE: To examine whether injection of bupivacaine into human intervertebral discs accelerates their degeneration. OVERVIEW OF LITERATURE: Bupivacaine is commonly used for therapy and diagnosis of discogenic low back pain. However, several in vitro studies have reported toxic effects of bupivacaine to disc cells. We sought to evaluate whether this finding is clinically relevant.
METHODS
We selected 46 patients with low back pain who showed disc degeneration at only one level (L4-L5 or L5-S1) on magnetic resonance imaging (MRI) (discography group, n=18), discoblock group (injection of bupivacaine, n=18), and a control group, n=10). There were no significant differences in baseline characteristics across the 3 groups. The two experimental groups underwent either discography or anesthetic discoblock, respectively. All three groups were followed up 5 years after the examination.
RESULTS
At 5 years follow-up, there was no significant difference in the rate of disc degeneration among the 3 groups (p>0.1). Moreover, X-ray images showed that there was no significant difference in disc height, range of motion, or translation between flex and extension position (p>0.1).
CONCLUSIONS
In conclusion, radiologic and MRI findings did not show acceleration of intervertebral disc degeneration at 5 years after a single injection of bupivacaine into human discs.

Keyword

Lumbar vertebrae; Intervertebral disc degeneration; Bupivacaine

MeSH Terms

Bupivacaine
Follow-Up Studies
Humans
Intervertebral Disc
Intervertebral Disc Degeneration
Low Back Pain
Lumbar Vertebrae
Magnetic Resonance Imaging
Prospective Studies
Range of Motion, Articular
Bupivacaine