Percutaneous minimally invasive treatment of lumbar disc herniation with radiopaque gelified ethanol: our experience

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-1432

Type:

Scientific Exhibit

Keywords:

Neuroradiology spine, Interventional non-vascular, Musculoskeletal spine, CT-Angiography, CT, Digital radiography, Efficacy studies, Experimental investigations, Treatment effects, Hernia, Outcomes, Motility

Authors:

G. Galvano, G. Tigano, S. De Luca, A. Cannella, G. Scavone, M. Messina, P. Aliffi, A. Scavone; Catania/IT

DOI:

10.1594/ecr2015/C-1432

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1432

Fig. 1: L4-L5 disc puncture under fluoroscopic guidance - PA projection

Fig. 4: L5-S1 disc puncture under fluoroscopic guidance - Lateral projection

Fig. 5: L4-L5 space after radiopaque gelified ethanol injection - PA projection

Aims and objectives

Disc herniation is a common cause of back pain and discomfort in the gluteal area and legs and affects all age groups. A multitude of therapies is available to treat lumbar disc herniation, from conservative methods (medication and physical therapy) to minimally invasive (percutaneous) treatment and surgery. The aim of this work is to determinate the effect of percutaneous minimally invasive treatment of lumbar disc herniation with radiopaque gelified ethanol.

Methods and materials

Twenty-two patients aged between 25 and 72 years were treated byradiopaque gelified ethanolbetween May 2014 and December 2014. Inclusioncriteria fortreatment with radiopaque gelified ethanol: • Chronic lumbago, cruralgia and sciatica resistant to conservative management; •Neuroradiological Imaging findings of uncalcified disc herniations withoutfree disc fragments,in a location congruent with symptoms; The procedure was performed using aposterior paravertebralapproachwith fluoroscopyassistance and under local anesthesia. Radiopaque gelified ethanol was introduced through a fine needle (18G) into the intervertebral disc without the need to open up the spinal canal. The...

Results

Outcomes were assessed three monthsafter treatment.A decrease of pain intensity and disability was found in 18 patients (82%) Three patients (18%) had no significantimprovement of symptoms.No treatment-linked complications occurred in any patient.

Conclusion

In our eperience patients who had chronic lumbago and sciatica resistant to conservative management with a contained lumbar disc herniation, treated withPercutaneous minimally invasive procedureusingradiopaque gelified ethanol had significantly reduced pain and disability.The treamentis safe and easy to handle and there were no complications related to the procedure.

Personal information

References

1. S. Stagni, F. DE Santis, L. Cirillo et al. A Minimally Invasive Treatment for Lumbar Disc Herniation: DiscoGel®Chemonucleolysis in Patients Unresponsive to Chemonucleolysis with Oxygen-OzoneInterventional Neuroradiology,Mar 2012 2. Steppan J, Meaders T, Muto M, et al. A meta-analysis of the effectiveness and safety of ozone treatments for herniated lumba disc.J Vasc Interv Radiol.2010;21:534–548 3. Riquelme C, Musacchio M, Mont’Alverne F, et al. Chemonucleolysis of lumbar disc herniation with ethanol.J Neuroradiol.2001;28:219–229 4. Théron J, Cuellar H, Sola T, et al. Percutaneous treatment of cervical disk...