LAUSR

Introduction/Background Nonspecific low back pain is first cause of years lived with disability. An active disc disease is present in up to 58% of patients with low back pain. We aimed to describe patients with chronic low back pain and an active disc disease who respond and those who do not respond to intradiscal glucocorticoid or to intradiscal contrast. Material and method We conducted a secondary analysis of the PREDID study, a randomized trial of 135 patients with chronic low back pain and an active disc disease. Overall, 61 participants received an intradiscal injection of glucocorticoid (25 mg prednisolone acetate) during discography and 60 received discography alone. Fourteen participants did not receive the allocated treatment and were not included in this secondary analysis. The primary outcome was the description of clinical, demographical, psychological and social characteristics of responders and non-responders to intradiscal glucocorticoid and to intradiscal contrast at 1 month, as defined in the primary trial. Independent variables associated to clinical response were assessed by logistic regression. Results Participants who responded to intradiscal corticosteroid injection were more often highly educated (18/34 [52.9%] vs. 6/26 [23.1%], respectively), whereas participants who did not respond were more often on sick leave (14/27 [51.9%] vs. 5/34 [14.7%]). The independent variable most strongly associated with the absence of therapeutic response to intradiscal glucocorticoid was sick leave (OR = 33.8, 95% CI = 2.4 to 472.2). Similar results were observed with response to intradiscal contrast injection but the magnitude of differences was lower. Conclusion Patients with chronic low back pain and an active disc disease who respond to an intradiscal injection of corticosteroids or contrast have a social profile different from those who do not respond. Registration ClinicalTrials.gov number NCT00804531 (First received: December 8, 2008. Last updated: June 23, 2016). Funding French Ministry of Health (Programme Hospitalier de Recherche Clinique, project No. P070157).