Collagen Therapy in Lumbar Spondylosis - a Pilot Study. Does the Route of Administration Matter?

To compare the effectiveness of three techniques of collagen injection in the treatment of low back pain (LBP) in lumbar spondylosis.

In this randomized prospective study, 30 patients with lumbar spondylosis were assigned to 3 groups: subcutaneous (Group A, n = 10), periradicular (Group B, n = 10) and epidural (Group C, n = 10). Collagen injections were administered once a week (4 injections in total). Assessment involved a visual pain scale (VAS) (0-10), Oswestry scale (0-50), Laitinen scale (0-16) and One Leg Stance Test (OLST) - time to onset of pain in the support limb. Patients were assessed at the start of treatment (W0), on completion of treatment (W1) and 1 month after completion of treatment (W2).

Improvement was seen with all three techniques of collagen administration. The minimal clinically important difference (MID) of 3 points on the VAS scale was noted in 44% of patients in Group A, 40% of patients in Group B and 60% of Group C. The MID for the Oswestry scale, determined at 10 points, was achieved in 56%, 50% and 20% of patients, respectively, while the MID for the Laitinen scale, determined at 4 points, was achieved in 56%, 30% and 40% of patients, respectively. All treated patients achieved the reference value of 30 seconds for OLST only in Group A.

Subcutaneous administration of collagen is not inferior in terms of effectiveness to periradicular and epidural injections in the treatment of LBP in lumbar spondylosis.