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Discogel; Initial experience in Iran (2015)

Percutaneous treatment of degenerative disc disease
with radiopaque gelified ethanol (Discogel);
Initial experience in Iran

 

Introduction:

Minimally-invasive treatments of degenerative disc disease

are becoming more popular. Various intradiscal

procedures have been introduced since many years

ago, with variable and inconsistent outcome.

Chemical neucleolysis has been performed using

multiple chemical substances including Chymopapain

and alcohol with limited success.

Discogel, a new similar substance composed of ethanol

mixed with ethyl cellulose and radiopaque material,

has been recently introduced with promising results.

In this study, we try to present our initial experience

with intradiscal injection of Discogel in Iranian patients,

to evaluate its efficacy and safety.

Methods: From August until December, we have

started our experience with Discogel in five centers

in Tehran, Iran. Seventy-four patients with symptomatic

lumbar or cervical disc herniation, who failed

conservative non-surgical treatment, were included into

the study. Protruded and extruded herniated disc without

sequestration, with disc height more than 50% of the

initial height, Pfirrman grading of III or IV, with radicular

symptoms more prominent than axial symptoms. 0.5 to 0.6 milliliters

of Discogel in cervical discs and 0.8 to 1.6 milliliters in

lumbar discs was injected under controlled

fluoroscopic/ CT scan guidance using standardized techniques.

Results: Seventy-four patients were injected, aged 20-78

(mean=44.4±9.7). There were 52 lumbar and 22 cervical operations.

This was the first intervention for all patients except for 3 of

them that had a history of previous operation at other levels.

The procedure lasted from 15 to 90 minutes depending on the

number of levels, and the whole admission took from 3 to 24

hours. Median VAS score was 10 before injection,

which dropped to 5 at 1 week post-injection, and 0 at 1 month

post-injection. Only 3 patient reported significant remaining

pain at 1 month of follow-up that underwent operation.

No complications were noted.

Conclusion: Initial results were promising, indicating

more than 95% of good and very good results.

This preliminary study shows efficacy and safety of

Discogel intradiscal injection in selected cases.

Further long-term follow-up is needed to evaluate the results.

 

Reference:

http://painmedicine.conferenceseries.com/abstract/

2015/percutaneous-treatment-of-degenerative-disc-

disease-with-radiopaque-gelified-ethanol-discogel-

initial-experience-in-iran

 

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