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

  • Seiji Ohtori
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Gen Inoue
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Sumihisa Orita
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Yawara Eguchi
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Nobuyasu Ochiai
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Shunji Kishida
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Kazuki Kuniyoshi
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Junichi Nakamura
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Yasuchika Aoki
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Tetsuhiro Ishikawa
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Masayuki Miyagi
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Hiroto Kamoda
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Miyako Suzuki
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Masashi Takaso
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Tomoaki Toyone
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Gou Kubota
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Yoshihiro Sakuma
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Yasuhiro Oikawa
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Kazuhide Inage
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Takeshi Sainoh
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
  • Kazuhisa Takahashi
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

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Prospective study of changes in intervertebral disc degeneration after injection of bupivacaine.To examine whether injection of bupivacaine into human intervertebral discs accelerates their degeneration.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.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.At 5 years follow-up, there was no significant difference in the rate of disc degeneration among the 3 groups (p0.1). Moreover, X-ray images showed that there was no significant difference in disc height, range of motion, or translation between flex and extension position (p0.1).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.

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