STUDY DESIGN Prospective study of changes in intervertebral disc degeneration after injection of bupivacaine. PURPOSE To examine whether injection of bupivacaine into human intervertebral discs accelerates their degeneration. OVERVIEW OF LITERATURE Bupivacaine is commonly used for therapy and diagnosis of discogenic low back pain. However, several in vitro studies have reported toxic effect...

Discogenic low back pain resulting from internal disc disruption can be severely disabling, clinically challenging, and expensive to treat. Previously, when conservative care had been exhausted, open surgical intervention such as spinal fusion or artificial disc replacement was the only treatment option for these patients. Intradiscal electrothermal therapy (IDET), a minimally-invasive techniqu...

INTRODUCTION The intervertebral disc (IVD) undergoes more extensive structural and compositional changes with age and degeneration than any other musculoskeletal tissue. With age and degeneration, tears appear within discs due to limiting diffusion of nutrients into the disc, alteration of chemical composition, and injuries. Disc tears are associated with low back pain [1,2]. The current clinic...

METHODS: We collected 46 samples of intervertebral discs from 38 patients during spinal fusion for chronic back pain. 30 samples were from pain levels clinically established by discography and 16 samples were from adjacent vertebral levels with no pain. We obtained 34 control samples of intervertebral disc from previously healthy individuals with normal histology within 8 h of recorded death. W...