Back Pain Lower Back Chronic Clinical Trial
Official title:
Intra-discal Steroid Injection for MODIC I Discopathy: A Randomized Control Trial
To assess the efficacy on pain level at 1 month and 12 months of a steroid injection in the
inter-vertebral disc for patients with chronic back pain and inflammatory discopathy on
magnetic resonance imaging.
Hypothesis: delivering anti-inflammatory drugs in situ may decrease back pain in patients
with inflammatory discopathy
Objective: to assess the efficacy on pain level of a steroid injection in the inter-vertebral
disc for patients with chronic back pain and MODIC I discopathy on MRI
Methods: a multicenter double blind randomized control trial Setting: 3 tertiary care
hospitals in France Patients: 134 patients with disabling chronic low back pain not relieved
by usual recommended treatments and MODIC I (inflammatory) discopathy on MRI Intervention:
Injection of 25 mg of methylprednisolone in the inter-vertebral disc during a discography
(intervention group, 67 patients) or discography alone (control group, 67 patients) Outcome
measures: The primary outcome measure is pain level assessed on a 11-point numeric scale
(0-100) at 1 month. Success is defined as less than 40 on pain numeric scale at 1 month.
Secondary outcome measures are pain level at 12 months, Disability (Quebec questionnaire),
quality of life (SF-12) at 1 and 12 months, anxiety and depression (HAD), analgesics and
anti-inflammatories during the last week, return to work, assessment of the disabilities at 1
and 12 months and disc inflammation (on MRI) at 12 months. Tolerance and adverse effects will
be recorded.
Trial duration: 36 months(24 months for inclusion and 12 months follow-up) Follow-up visits:
at 1, 3, 6, and 12 months Statistical analysis: intention to treat
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