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Effects of Single Injection of Local Anesthetic Agents on Intervertebral Disc Degeneration : Ex Vivo and Long-Term In Vivo Experimental Study

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Title: Effects of Single Injection of Local Anesthetic Agents on Intervertebral Disc Degeneration : Ex Vivo and Long-Term In Vivo Experimental Study
Authors: Iwasaki, Koji Browse this author
Sudo, Hideki Browse this author →KAKEN DB
Yamada, Katsuhisa Browse this author
Higashi, Hideaki Browse this author →KAKEN DB
Ohnishi, Takashi Browse this author
Tsujimoto, Takeru Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Issue Date: 6-Oct-2014
Publisher: Public Library of Science
Journal Title: PLOS one
Volume: 9
Issue: 10
Start Page: e109851
Publisher DOI: 10.1371/journal.pone.0109851
Abstract: Background: Analgesic discography (discoblock) can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD) cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model. Methods: For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine). Nucleus pulposus (NP) cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI) and histological analysis. Results: In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline-and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups. Conclusions/Significance: In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents on degenerated IVDs.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 須藤 英毅

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