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Pardatscher K, Volpentesta G, Bombardieri C, Giaquinta A. Percuta- over, these techniques cannot be used when there is evi- neous treatment of lumbar intervertebral disc hernias with disco- gel. Neuroradiol J. 2011;24(4):627-35. doi: 10.1177/197140091102400420. dence of calcified herniation or free disc fragments.
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To determine the impact of ethanol gel chemonucleolysis (EGCh). Before surgery, the mean heights were 10.08 (2.05) for women and 11.69 (2.13) for men. After the procedure, the mean heights were 9.98 (2.06) for women and 11.57 (2.17) for men . There was an increase in disc height at the level affected in 61% of patients: 29% at the lower.
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For the RLP patients, the corresponding values dropped 48% (7.05 vs. 3.68) and 54% (6.77 vs. 3.13). There were no differences between the cohorts in COMI and VAS at the follow-up end. Six months into the study, 74% of DP and 81% of RLP patients did not use any analgesics. Ethanol gel therapy can be effective for many patients.
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Minimally invasive DiscoGel therapy involves the percutaneous injection of an ethanol gel into the degenerated disk's nucleus pulposus. This paper compares the 1-year outcome of such treatment in DP and RLP patients.
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There was no significant evidence for an overall difference in pain score between the two groups (analysis of variance, F = 3.24, df = 1, P = 0.084), except for the sixth and 12th months, when group B presented a statistically important difference compared with group A (Wilcoxon test).Group B appeared to be more effective, with a statistically significant difference, compared with group A.
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The amount of DiscoGel ® injected into the disc depends on the amplitude of the disc space and the relative capacity of the disc to accommodate the gel, usually between 0.5-0.8 mL. The needle is left in place for 2 minutes after the application to prevent late leakage [ 11 , 13 ].
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A wide range of minimally invasive percutaneous treatments for lumbar disc herniation have been implemented in recent years: chemodiscolysis with chimopapain; Onik's automated percutaneous lumbar discectomy (APLD); percutaneous laser disc decompression (PLDD); intradiscal electrothermal therapy (IDET); percutaneous coblation nucleoplasty; Dekomp.
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It is injected into the nucleus pulposus to reduce intradiscal pressure. The presence of cellulose, which is a gelling agent, limits the risk of epidural leaks that may occur with pure ethanol. The tungsten particles are used to control progression of the gel in the disc and through any annular fissures by fluroscopic control.
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DISCOGEL® is an implantable medical device based on jellified ethanol in which an opaque agent in X-rays: the tungsten was added. The principle of the making of the implant in the presence of water was filmed. Click on the following picture to show it: DISCOGEL® allows treating herniated discs by decompression.
