Percutaneous treatmtent of cervical disc herniations using Discogel: preliminary results

Congress:

ECR 2020

Poster Number:

C-09631

Type:

Scientific Exhibit

Keywords:

Interventional Radiology, Interventional non-vascular, Musculoskeletal spine, Fluoroscopy, Surgery, Technical aspects, Hernia, Not applicable, Observational, Performed at one institution

Authors:

R. Fiori¹, C. Di Donna², M. Forcina², L. Spiritigliozzi², A. U. Cavallo¹, R. Floris²; ¹Rome/IT, ²Roma/IT

DOI:

10.26044/ecr2020/C-09631

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-09631

Fig. 1: Upper side:Needle positioning Low side: AP(left side) and LL( right side)...

Fig. 2: AP and LL projections after Discogel injection

Fig. 3: Axial and Sagittal MRI images before the procedure(upper side)showing the...

Purpose

Cervical discogenic pain is usually caused by degenerated intervertebral discs. Cervical discs may herniate and give compressions to cervical nerves, with pain extended to the arms[1]. Discogel is a new device that can be very helpful to treat cervical disc herniation, with very short operating time and low radiation exposure. The aim of this study is to analyze and evaluate the feasibility, effectiveness and safety profile of DiscoGel® in the treatment of degenerative cervical disease.

Methods and materials

Between july 2018 and march 2019 we performed this innovative procedure on 18 patients(from35 y.o. to 65 y.o.) with non fissurated cervical disc herniation. Most common level interested was C5-C6 (89%) and C6-C7 (11%). Each patient was evaluated by objective examination and clinical examination. For each patient the assessment of pain-disability was performed, using: -Visual Analogue Scale – VAS [2] -Oswestry Disability Index – ODI [3] -Neuropatic Pain in 4 Questions – DN4 [4] These scales were administered before the procedure (time 0) and after...

Results

The average fluoroscopy time was 4 minutes 42 seconds and the average DAP was 2804 mGy/cm2. We obtained a significat reduction of pain, with no complications. At time 0 the average pain score evaluated on the VAS scale was 8 ± 0.67, ODI scale score was 75.08 ± 8.69 and DN4 score was 7.24 ±1.45. Post-operative examinations showed: VAS 3,9 ± 1.48, ODI 12 ± 3.54 and DN4 2,20 ± 0.79. A qualitative comparison of pre and post-procedure MRIs at 6 months showed that in...

Conclusion

DiscoGel® can be an effective, safe and reliable therapeutic solution for the treatment of painful symptoms following disc degeneration, including of the cervical tract.

Personal information and conflict of interest

C. Di Donna; Rome/IT - nothing to disclose R. Fiori; Rome/IT - nothing to disclose M. Forcina; Rome/IT - nothing to disclose L. Spiritigliozzi; Rome/IT - nothing to disclose A. U. Cavallo; Rome/IT - nothing to disclose R. Floris; Rome/IT - nothing to disclose

References

1.Woods, B. I. & Hilibrand, A. S. Cervical radiculopathy: Epidemiology, etiology, diagnosis, and treatment. Journal of Spinal Disorders and Techniques 28, E251–E259 (2015). 2.Johnson, E. W. Visual analog scale (VAS). American Journal of Physical Medicine and Rehabilitation 80, 717 (2001). 3. Fairbank, J. C. T. & Pynsent, P. B. The Oswestry Disability Index. Spine (Phila. Pa. 1976). 25, 2940–2953 (2000). 4.Finnerup, N. B. et al. Neuropathic pain: An updated grading system for research and clinical practice. Pain 157, 1599–1606 (2016). 5.Theron, J. et al. Percutaneous...