The Clinical Study Of Methylene Blue Injection Combined With Targets Radiofrequency Treat Discogenic Low Back Pain

Obejective:To further enhance the clinical efficacy of the method of discogenic low backpain (DLBP), the use of methylene blue injection combined with radiofrequencyablation target disc disease, researchers combined two different mechanism of thetherapeutic effect.To measure the area of the high intensity zone (HIZ), which islocated posterior to the intervertebral disc, on magnetic resonance imaging (MRI) T2sagittal image in patients with discogenic low back painduring the early stage afteroperation; to investigate the relationship between its variation and the clinical effect,and thereby study its value in assessing the treatment effect in DLBP.Methods:A total of45patients with DLBP who failed in conservative treatment wereenrolled and divided into3groups: A group (15cases) treated with methylene blue, Bgroup (15cases) treated with radiofrequency thermocoagulation, and C group (15cases) treated by methylene blue injection combined with radiofrequency. OswestryDisability Index (ODI) was applied to estimate the clinical effect and thus it wasevaluated preoperative,1week,3and6months after operation., respectively.Meanwhile, T2-weighted MRI was employed to survey the area of the HIZ at the rearof the protruded disc before and6months following the treatment. Data wereanalyzed by using SPSS19.0.Results:All cases were followed up. Compared with the preoperative ODI scores, thescores of1week,3and6months deceased (P<0.05). Besides, there also werevariabilities among different groups: the scores in C group were lower than those of Aand B groups with significant statistical differences (P<0.05); at the same time, theODI scores ofAgroup were lower than B group (P<0.05).In addition, the MRI T2images demonstrated that the HIZ areas in the6monthafter operation were diminished in all of the three groups when comparing with thepreoperative parameters and had statistic significance (P<0.05). The reductions in C group and B group were more remarkable than A groups. It was significantly differentamong3groups (P<0.05).According to the relevance analysis of the ODI score and the HIZ area in the6month postoperatively the correlation of the3groups are: RA=0.297,R2A=0.08(P=0.283>0.05）；RB=0.619，R2B=0.38(P=0.014<0.05）；RC=0.579，R2C=0.33（P=0.024<0.05）, they were low correlated with each other in B and Cgroups, whereas there was no significant correlation inAgroup.Conclusion:Among the three therapeutic regimens, methylene blue injection combined withradiofreqency is the best way for treating DLBP. Early postoperative HIZ changes inthe area and the curative effect have a certain relationship with each other, but are notclosely related.Taken together, our results reveal that the HIZ area may not be aprincipal indicator for supervising the curative effects in the treatment of DLBP.