1School of Medicine, College of Medicine, National Cheng Kung University, Taiwan
2Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
3Department of Anesthesiology, Tainan Hospital, Ministry of Health and Welfare, Taiwan
Outline
Background
Discography has long been used as diagnostic tool for patients suffering from chronic low back pain. It offers more clinical clues for physicians and aids future treatment planning. The aim of this case report is to reveal possible therapeutic effects other than the current well-known diagnostic features that may thereby benefit more patients with similar clinical findings.
Case presentation
A 55-year-old woman presented in our pain clinic with left posterior lateral thigh and leg pain that had lasted for three years. The pain was approximately a 7 on the Visual Analogue Scale (VAS) (score ranging from 0~10, with 0 as no pain at all, and 10 as the worst pain in life). The MRI showed central herniation of the L5-S1 disc, so discography was scheduled for further confirmation of discogenic low back pain. The discography was done smoothly without contrast leakage, and no back pain was induced. Pulse-dose radiofrequency (RF) on left L5 dorsal root ganglion (DRG) was performed for further treatment. Much to our surprise, the patient revisited the pain clinic and reported a VAS reduction to 2 after the procedure. We continued follow-up, and her pain still low (VAS=3-4) even a long as three months later. However, she had gradually relapsed by her 4-month
visit.
Conclusion
We review the current treatment options for patients with chronic discogenic low back pain and discuss the possible mechanism of pain relief in our case.
Discography, Radiofrequency, Low back pain
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