Infiltrations intradiscales d’acétate de prednisolone dans les lombalgies sévères. Recherche de complications radiologiques

Abstract

Objectives. – To investigate complications (calcification and/or disc collapse) as seen on radiography and patient-assessed effectiveness after intradiscal injections of acetate of prednisolone (Hydrocortancyl ®). Materials and methods. – A retrospective study of medical records of 67 patients (68 injected discs) given an intradiscal injection of acetate of prednisolone for low back pain with endplate signal changes on magnetic resonance imaging and/or evidence of fast destructive discopathy, as well as records of 85 patients (55 women, mean age 49 ±9 years) to assess the effectiveness of intradiscal injection: the global appreciation of the patient (excellent, good, mild, none, worse) concerning the result of the intradiscal injection at one, three and six months. Two physicians were blinded during analysis of images. Results. – The mean period of follow up for radiographics was 10.25 ±5.99 months. A total of 44.8% of the patients had control at six months and 38.8% at 12 months or more. No calcification was found, but two discs showed a collapse of 20 and 25% at six and 12 months, respectively, after the injection. For effectiveness of intradiscal injection, 71.8% the patients considered the result good or excellent at one month, 55.3% at three months and 43.5 % at six months. Conclusion. – The benefit-to-risk ratio of use of acetate of prednisolone intradiscal injection seems good in selected patients with low back pain.