<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2019-0026_s_006_w2aab3b7c13b1b6b1aab1c18b1Aa"><h3>Background</h3><p>Percutaneous image-guided intradiscal injection of gelified ethanol was introduced to treat herniated disc disease lately. The aim of the study was to assess clinical efficacy and durability over a 36 months’ period.</p></sec><sec id="j_raon-2019-0026_s_007_w2aab3b7c13b1b6b1aab1c18b2Aa"><h3>Patients and methods</h3><p>Eighty-three patients (47 males, 36 females, mean age 48.9 years (18–79 years) were treated between May 2014 and December 2015 for 16 cervical and 67 lumbar chronical contained disc herniations. For pain assessment evaluation, the visual analog scale (VAS) was used. Physical activity, the use of analgesics, patients’ satisfaction with the treatment results and patient’s willingness to repeat the treatment were also evaluated.</p></sec><sec id="j_raon-2019-0026_s_008_w2aab3b7c13b1b6b1aab1c18b3Aa"><h3>Results</h3><p>Fifty-nine patients responded to questionnaire. 89.8% had significant reduction in VAS after 1 month (p &lt; 0.001); 76.9% of patients with cervical symptoms and 93.5% of patients with lumbar symptoms. In cervical group it remained stable, while in lumbar group VAS decreased even more during 36 months (p = 0.012). Single patient had spinal surgery. Moderate and severe physical disability prior to treatment (96.6%) was reduced to less than 30% after 12 months. The majority of active patients returned to their regular job (71.1%); 78% needed less analgesics. Only 5.1% patients were not satisfied with the treatment and 10.2% would not repeat the treatment if needed.</p></sec><sec id="j_raon-2019-0026_s_009_w2aab3b7c13b1b6b1aab1c18b4Aa"><h3>Conclusions</h3><p>Percutaneous image-guided intradiscal injection of gelified ethanol is safe, effective and durable therapy for chronic contained cervical and lumbar herniations. Due to minimal invasiveness and long-lasting benefits, this kind of treatment should be proposed to designated group of patients as first-line therapy.</p></sec></abstract>

BackgroundPercutaneous image-guided intradiscal injection of gelified ethanol was introduced to treat herniated disc disease lately. The aim of the study was to assess clinical efficacy and durability over a 36 months’ period.Patients and methodsEighty-three patients (47 males, 36 females, mean age 48.9 years (18–79 years) were treated between May 2014 and December 2015 for 16 cervical and 67 lumbar chronical contained disc herniations. For pain assessment evaluation, the visual analog scale (VAS) was used. Physical activity, the use of analgesics, patients’ satisfaction with the treatment results and patient’s willingness to repeat the treatment were also evaluated.ResultsFifty-nine patients responded to questionnaire. 89.8% had significant reduction in VAS after 1 month (p < 0.001); 76.9% of patients with cervical symptoms and 93.5% of patients with lumbar symptoms. In cervical group it remained stable, while in lumbar group VAS decreased even more during 36 months (p = 0.012). Single patient had spinal surgery. Moderate and severe physical disability prior to treatment (96.6%) was reduced to less than 30% after 12 months. The majority of active patients returned to their regular job (71.1%); 78% needed less analgesics. Only 5.1% patients were not satisfied with the treatment and 10.2% would not repeat the treatment if needed.ConclusionsPercutaneous image-guided intradiscal injection of gelified ethanol is safe, effective and durable therapy for chronic contained cervical and lumbar herniations. Due to minimal invasiveness and long-lasting benefits, this kind of treatment should be proposed to designated group of patients as first-line therapy.

Efficacy and durability of radiopaque gelified ethanol in management of herniated discs

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundPercutaneous image-guided intradiscal injection of gelified ethanol was introduced to treat herniated disc disease lately. The aim of the study was...

	Serious limitations	Moderate limitations	Mild limitations	No limitations
Prior to therapy	38/59 (64.4%)	19/59 (32.2%)	2/59 (3.4%)	0
6 months after	3/59 (5.1%)	22/59 (37.3%)	26/59(44.1%)	8/59 (13.5%)
After 1 year	2/59 (3.4%)	15/59 (25.4%)	32/59(54.2%)	10/59 (16.9%)

Lumbar spine	L4–L5 (45 pts; 67.2%)	L5–S1 (30 pts, 44.8%)
Cervical spine	C5–C6 (11 pts, 69%)	C3–C4/ C6–C7 (5 pts, 31%)

	CERVICAL SPINE	LUMBAR SPINE
Prior to therapy	8.6 (8,0)	8,5 (8,0)
After 1 month	4.1 ( no data)	4,5 (3,7)
After 6 months	3,8 (6,3)	3,7 (3,3)
After 1 year	3,9 (7,3)	2.8 (2,6)
After 2 years	3,7 (6,8)	2.6 (2,4)
After 3 years	3,9 (7,3)	2,4 (2,1)

Single level	Two levels	Three levels	Four levels
46 pts (55.5%)	27 pts (32.5%)	9 pts (10.8%)	1 pt (1.2%)
(C -10 pts/ L-36 pts)	(C- 3 pts/ L-24 pts)	(C- 3 pts/ L-6 pts)	(L- 1 pt)

Efficacy and durability of radiopaque gelified ethanol in management of herniated discs

Article Category: Research Article

Published Online: Jun 01, 2019

Page range: 187 - 193

Received: Feb 21, 2019

Accepted: Apr 25, 2019

DOI: https://doi.org/10.2478/raon-2019-0026

© 2019 Dimitrij Kuhelj, Anita Dobrovolec, Igor Jozef Kocijancic, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Figure 4

Mean physical activity

Satisfaction with the treatment

The distribution of most commonly affected spine segments

Willingness to repeat the treatment- cervical

Willingness to repeat the treatment in all patients

Mean VAS reduction (radicular pain in parenthesis)

The use of analgesics after the treatment

The No. of levels treated in patients with herniated discs