Comparison of the effect of diagnosing discogenic low back pain by sinuvertebral nerve block versus discoblock a retrospective cohort study

Abstract

Purpose: The purpose of this study was to evaluate the efficacy of sinuvertebral nerve blocks in the diagnosis of discogenic low back pain.

Patients and methods: In this retrospective cohort study, the data of 48 patients with high clinical suspicion of discogenic low back pain from L4/5 who received nerve block treatment from 2017 to 2018 were collected. Twenty-four patients received discoblock (L4/5 intradiscal injection of 1 ml 0.5% lidocaine) and another 24 patients received the sinuvertebral nerve block(L4/5 intervertebral space injection of 0.5 ml 0.5% lidocaine bilaterally). Percutaneous endoscopic radiofrequency thermal annuloplasty was performed in patients who responded to the diagnostic block. The visual analogue scale scores and Oswestry Disability Index scores in both groups before and 1, 3, and 12 months after surgery were compared.

Results: Ten patients with a negative diagnostic block did not undergo surgery. Eighteen patients in the discoblock group and 20 patients in the sinuvertebral nerve block group showed a positive response and were evaluated. There were no differences in visual analogue scale or Oswestry Disability Index scores between the two cohorts at baseline or at all time points postsurgery (all p > 0.05). When comparing baseline values to all time points postsurgery improved visual analogue scale scores, and Oswestry Disability Index scores were observed within both cohorts (all p < 0.05).

Conclusion: The effect of sinuvertebral nerve block as a diagnostic tool for discogenic low back pain is similar to that of discoblock, and it is a promising tool that deserves further study.

Keywords: Diagnostic nerve block; Disc degeneration; Discogenic low back pain; Discography; Sinuvertebral nerve.