What is the role of intradiskal therapies in the management of low back pain (LBP) and sciatica?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Multiple intradiskal therapies have been developed to manage diskogenic pain. The disk is frequently implicated as causative in many painful spinal and radicular syndromes. A prospective randomized double-blind study of interdiskal injections into diskography-confirmed painful disks showed no statistically significant benefit or effective pain relief between corticosteroids and local anesthetics. [199] The use of diagnostic diskography has been combined with therapeutic percutaneous intradiskal procedures in patients who demonstrate a concordant pain response. Among others, intradiskal therapies include chymopapain injections to achieve nucleolysis and percutaneous procedures such as manual nucleotomy with nucleotome, nucleoplasty, automated lumbar diskectomy, laser diskectomy, percutaneous disk decompression, and RF posterior annuloplasty. [200]


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