Intraarticular Triamcinolone versus Hyaluronate Injections for Low Back Pain with Symptoms Suggestive of Lumbar Zygapophyseal Joint Arthropathy: A Pragmatic, Double Blind Randomized Controlled Trial

AbstractObjectiveTo compare hyaluronate to triamcinolone injections in treating chronic low back pain (CLBP) suggestive of lumbar zygopophyseal joint (ZJT) arthropathy.DesignProspective, double-blind, randomized controlled trial. 30 subjects were randomly assigned to receive bilateral L3-S1 ZJT injections with triamcinolone (KA) or Synvisc-One® (HA). Pain [Visual Analog Scale (VAS)] and Pain Disability Questionnaire (PDQ) scores at 1, 3, and 6-months were evaluated.ResultsNo significant inter-group differences (p>.05) in outcomes were noted in the 30 recruited subjects. (KA/HA, baseline; 1-month; 3-month; 6-month)-VAS scores: 70±15/74±10; 58±29/45±25; 58±29/56±25; 59±28/63±24. PDQ scores: 100±23/102±28; 77±30/74±34; 87±26/74±36; 96±25/79±25. Overall percent improvement@6months: KA(51±35) and HA(42±33) [p=.51]. HA group VAS scores improved significantly (70±20 to 45±25@1m, p=.008). PDQ scores improved at 1m (100±23 to 77±30, p=.009) in the KA group and at all time points in the HA group (102±28 to 74±34@1m, p=.002; 74±36@3m, p=.037; 79@6m [Median; 52-99.5, p<.001 medians and quartiles were used in statistical analysis when data did not pass normality.conclusionspatients with clbp suggestive of lumbar zjt arthropathy responded similarly to triamcinolone or hyaluronate injections. ha group showed significant short- long-term functional improvement short-term pain ka only benefit no improvement. objective compare injections treating chronic low back zygopophyseal joint arthropathy. design prospective double-blind randomized controlled trial. subjects randomly assigned receive bilateral l3-s1 synvisc-one analog scale disability questionnaire scores at evaluated. results inter-group differences>.05) in outcomes were noted in the 30 recruited subjects. (KA/HA, baseline; 1-month; 3-month; 6-month)-VAS scores: 70±15/74±10; 58±29/45±25; 58±29/56±25; 59±28/63±24. PDQ scores: 100±23/102±28; 77±30/74±34; 87±26/74±36; 96±25/79±25. Overall percent improvement@6months: KA(51±35) and HA(42±33) [p=.51]. HA group VAS scores improved significantly (70±20 to 45±25@1m, p=.008). PDQ scores improved at 1m (100±23 to 77±30, p=.009) in the KA group and at all time points in the HA group (102±28 to 74±34@1m, p=.002; 74±36@3m, p=.037; 79@6m [Median; 52-99.5, p<.001 medians and quartiles were used in statistical analysis when data did not pass normality. conclusions patients with clbp suggestive of lumbar zjt arthropathy responded similarly to triamcinolone or hyaluronate injections. ha group showed significant short- long-term functional improvement short-term pain ka only benefit no improvement. affiliation where the research was conducted correspondence: thiru m. annaswamy md ma s. lancaster road dallas tx-75216. email: thiru.annaswamy author disclosures: this funded by any grant foundation agency. paper is report a clinical trial. however trial time period at which point there requirements for all trials be registered. therefore rct does have registration registry. abstract previously presented at: tm armstead c avraham r carlson l bierner sm. scientific presentations: intraarticular vs. injections zygapophyseal joint arthropathy: pragmatic double blind randomized controlled presentation. annual assembly aapmr. boston ma. september pm page s91. doi: http: versus abstracts papers posters meeting association academic physiatrists san antonio tx. american journal physical medicine rehabilitation supplement a6-a7. march copyright wolters kluwer health inc. rights reserved.>

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