Intradiskal Injection of Methylene Blue for Discogenic Back Pain: A Meta-Analysis of Randomized Controlled Trials

Abstract

Abstract Introduction Intradiskal injection of methylene blue has some potential in alleviating discogenic back pain. This meta-analysis aims to explore the impact of intradiskal injection of methylene blue for discogenic back pain. Methods Several databases such as PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases have been searched through November 2019, and randomized controlled trials (RCTs) assessing the effect of intradiskal injection of methylene blue for discogenic back pain are included. Results Three RCTs are included in the meta-analysis. Overall, compared with control group for discogenic back pain, intradiskal injection of methylene blue remarkably decreased pain scores at 3 months (mean difference [MD] = –0.71; 95% confidence interval [CI] = –0.96 to –0.46; p < 0.00001) and 6 months (MD = –13.92; 95% CI = –22.31 to –5.54; p = 001) and Oswestry Disability Index (ODI) at 4 to 6 weeks (MD = –10.39; 95% CI = –16.95 to –3.83; p = 0.002) and 3 months (MD = –3.66; 95% CI = –4.85 to –2.48; p < 0.00001), but demonstrated no obvious effect on ODI at 6 months (MD = –11.76; 95% CI = –33.33 to 9.80; p = 0.28). Conclusions Intradiskal injection of methylene blue can substantially decrease pain scores and improve function for discogenic back pain.