Investigation the effect of Orthokine injection into the disc and intervertebral foramen to control the pain caused by lumbar disc herniation

Abstract

The aim of this study was to determine the effect of Orthokine injection into the disc and intervertebral foramen to control the pain caused by lumbar disc herniation Material and Method: The present study was performed as an open labeled interventional study on the study population including patients with radicular low back pain caused by disc herniation referred to the outpatient clinic of palliative medicine and pain in Imam Reza Hospital in 1399. The participants were included in the study by available sampling method and were randomly assigned to three groups using random blocking method. In the first group, orthokine was injected into the intervertebral foramen and repeated up to three injections once a week. In the second group, ortokin was injected into the intervertebral disc and repeated up to three doses once a week, and in the third group, they were treated with medication and rest. Patients who received at least 1 dose of orthokine were asked to carefully assess the intensity of daily pain, medication, and side effects (AE) before intervention (T0) and at 1 week (T1) and the first month (T2) after beginning of treatment. Results: A total of 31 patients with lumbar disc herniation were studied, including 12 men and 19 women. The mean age of patients was 43.65 ± 11.16 years. Pain intensity at week 1 and week 4 compared to baseline decreased significantly in the foramenal group (mean changes - 5.90 ± 2.38 and -8.54 ±1.96, respectively) also in the intradiscal group (mean changes of -4.60 ± 0.96 and -5.00 ±0.81, respectively) and also in the control group (mean changes of -4.00 ± 1.15 and -8.55 ±1.96, respectively). The mean of these changes in the first week did not show a significant difference between the three groups (p = 0.146). However, the mean of these changes in the 4th week compared to baseline values were significantly different between the three groups (p = 0.001). Also, in pairwise comparisons in the fourth week, the mean of pain reduction in the foraminal injection group was significantly higher than the intradiscal injection group (p = 0.001) and the control group (p = 0.001). The rate of drug discontinuation and return to work in the foraminal injection group was significantly higher than the intradiscal injection group and the control group during the 4 weeks of intervention. The ortokin was very well tolerated among the participants.