INTRODUCTION: Bupivacaine is commonly used for therapy and diagnosis for discogenic low back pain. However, several authors have reported toxic effects of bupivacaine to disc cells in vitro. We sought to evaluate whether such effects are seen clinically.
METHODS: We selected 30 patients with low back pain who showed disc degeneration at only one level (L4‐5 or L5‐S1) on magnetic resonance imaging (MRI) (discography group, discoblock group (injection of bupivacaine), and a control group, 10 patients each). There was no significant difference in disc degeneration based on Pfirmann's classification, disc height, range of motion, or translation between flex and extension position among the 3 groups. Two groups underwent discography or anesthetic discoblock respectively. Three groups were followed up 3 years after the examination.
RESULTS: At 3 years follow‐up, there was no significant difference in disc degeneration based on Pfirmann's classification among the 3 groups (P > 0.1). Moreover, X‐ray film images showed that there was no significant difference in disc height, range of motion, or translation between flex and extension position among the 3 groups (P > 0.1).
DISCUSSION: In conclusion, we did not show acceleration of intervertebral disc degeneration within 3 years after injection of bupivacaine into human discs. We concluded that there is a difference between clinical effects of bupivacaine on intervertebral discs compared with the effects seen in vitro.