A minimally invasive treatment for lumbar disc herniation: DiscoGel? chemonucleolysis in patients unresponsive to chemonucleolysis with oxygen-ozone

摘要

A multitude of therapies is available to treat disc herniation, ranging from conservative methods (medication and physical therapy) to minimally invasive (percutaneous) treatments and surgery. O 2-O 3 chemonucleolysis (O 2-O 3 therapy) is one of the minimally invasive treatments with the best cost/benefit ratio and lowest complication rate. Another substance recently made available exploiting the chemical properties of pure ethanol is DiscoGel?, a radiopaque gelified ethanol more viscous than absolute alcohol 8,9. The present study aimed to assess the therapeutic outcome of DiscoGel? chemonucleolysis in patients with lumbar disc herniation unresponsive to O 2-O 3 therapy. Thirty-two patients aged between 20 and 79 years were treated by DiscoGel? chemonucleolysis between December 2008 and January 2010. The treatment was successful (improvement in pain) in 24 out of 32 patients. DiscoGel? is safe and easy to handle and there were no complications related to product diffusivity outside the treatment site. The therapeutic success rate of DiscoGel? chemonucleolysis in patients unresponsive to O 2-O 3 therapy was satisfactory. Among other methods used to treat lumbar disc herniation, DiscoGel? chemonucleolysis can be deemed an intermediate procedure bridging conservative medical treatments and surgery.