Blue M&Ms 'mend spinal injuries'

[Justin]

Justin, it said in the above report that the BBG was administered intravenously. How does that get the dye directly to the spine where it was injured? And is this why the mice turned blue, because the dye went everywhere? Why wouldn't they inject it at the site like I am having done next week? It said that "No one wants to put a needle into a spinal cord that has just been severely injured so we knew we needed another way." That's where the IV came in, I guess.

The brilliant blue g dye is able to cross the blood-brain barrier; thus, it has access to the spinal cord via IV.

I think the reasoning behind the IV is that it is easier, quicker to do and they don't have to risk extra trauma to the spinal cord by injecting it directly at the site of injury in a patient with a spinal cord injury. Essentially, it comes down to ease. Placing an IV in a patient is quick and when access is established in the vein, you really don't have to worry about it (usually once the IV is in, the patient is "good to go").

But does that mean that I risk injury as well? The surgeon is injecting the dye right after doing the dicogram. There has been several discussions lately about the dangers of doing a discogram on the cervical area. Is the lumbar safer somehow? Maybe I should stick to the discogram, and why would that be any safer than the quote from the study above?

Am I 'thinking' too much again?

Personally, I don't think you are at increased risk. However, discography does carry an inherent risk, but with the advent and refining of techniques over the years, it is a relatively safe procedure.

The lumbar disogram is "safer" in a way because the spinal cord ends at the L2 vertebral level in adults.

The previous discussions on cervical discography on this forum have discussed patient cases that already have cervical myelopathy, or damage to the spinal cord itself in their cervical spine. The slight enlargement of the disc during discography carries the theoretical risk of exacerbating the myelopathy. (Note: cervical stenosis is different than cervical myelopathy. Cervical stenosis is the name for the actual narrowing of the canal, while cervical myelopathy indicates injury to the spinal cord and its function.)

Here's a good resource for further reading on cervical stenosis and myelopathy by the North American Spine Society (Public Education Series):

Click here: Cervical Stenosis & Myelopathy -- North American Spine Society Public Education Series

I hope this helps! :thumpup:

[Justin]

Pain
Volume 149, Issue 1, April 2010, Pages 124-129

A randomized placebo-controlled trial of intradiscal methylene blue injection for the treatment of chronic discogenic low back pain

Baogan Penga, b, Xiaodong Panga, Ye Wub, Changcheng Zhaoc and Xinghua Songd. a Department of Spinal Surgery, General Hospital of Armed Police Force, Beijing 100039, China. b Department of Orthopaedics, 304th Hospital, Beijing, China. c Department of Orthopaedics, Sanhe People Hospital, Hebei, China. d Department of Orthopaedics, Shengli Hospital, Shandong, China. © 2010 International Association for the Study of Pain Published by Elsevier B.V.

A preliminary report of clinical study revealed that chronic discogenic low back pain could be treated by intradiscal methylene blue (MB) injection. We investigated the effect of intradiscal MB injection for the treatment of chronic discogenic low back pain in a randomized placebo-controlled trial. We recruited 136 patients who were found potentially eligible after clinical examination and 72 became eligible after discography. All the patients had discogenic low back pain lasting longer than 6 months, with no comorbidity. Thirty-six were allocated to intradiscal MB injection and 36 to placebo treatment. The principal criteria to judge the effectiveness included alleviation of pain, assessed by a 101-point numerical rating scale (NRS-101), and improvement in disability, as assessed with the Oswestry Disability Index (ODI) for functional recovery. At the 24-month follow-up, both the groups differed substantially with respect to the primary outcomes. The patients in MB injection group showed a mean reduction in pain measured by NRS of 52.50, a mean reduction in Oswestry disability scores of 35.58, and satisfaction rates of 91.6%, compared with 0.70%, 1.68%, and 14.3%, respectively, in placebo treatment group (p < 0.001, p < 0.001, and p < 0.001, respectively). No adverse effects or complications were found in the group of patients treated with intradiscal MB injection. The current clinical trial indicates that the injection of methylene blue into the painful disc is a safe, effective and minimally invasive method for the treatment of intractable and incapacitating discogenic low back pain.

Discogenic low back pain; Discography; Methylene blue; Injection

[Cindylou]

Justin, I don't get how it works, but way cool. Thx, as always, for bringing us just relevant articles. :thumpup: