• Scott Miller, Marc Caragea, Dan Carson, Mary M McFarland, Masaru Teramoto, Daniel M Cushman, Amanda N Cooper, Taylor Burnham, Zachary L McCormick, and Aaron Conger.
• Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT 84108, United States.
• Pain Med. 2024 Jan 4; 25 (1): 334633-46.

ObjectiveDetermine the effectiveness of intradiscal corticosteroid injection (IDCI) for the treatment of discovertebral low back pain.DesignSystematic review.PopulationAdults with chronic low back pain attributed to disc or vertebral end plate pain, as evidenced by positive provocation discography or Modic 1 or 2 changes on magnetic resonance imaging.InterventionFluoroscopically guided or computed tomography-guided IDCI.ComparisonSham/placebo procedure including intradiscal saline, anesthetic, discography alone, or other active treatment.OutcomesReduction in chronic low back pain reported on a visual analog scale or numeric rating scale and reduction in disability reported by a validated scale such as the Oswestry Disability Index.MethodsFour reviewers independently assessed articles published before January 31, 2023, in Medline, Embase, CENTRAL, and CINAHL. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. The risk of bias in randomized trials was evaluated with the Cochrane Risk of Bias tool (version 2).ResultsOf the 7806 unique records screened, 6 randomized controlled trials featuring 603 total participants ultimately met the inclusion criteria. In multiple randomized controlled trials, IDCI was found to reduce pain and disability for 1-6 months in those with Modic 1 and 2 changes but not in those selected by provocation discography.ConclusionAccording to GRADE, there is low-quality evidence that IDCI reduces pain and disability for up to 6 months in individuals with chronic discovertebral low back pain as evidenced by Modic 1 and 2 changes but not in individuals selected by provocation discography.Study RegistrationPROSPERO (CRD42021287421).© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

14 keywords...

hide…