title: [Unsatisfactory results of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica caused by intervertebral disk herniation].
abstract: Sciatica caused by intervertebral disc herniation can be treated with intradiscal injection of chymopapain. A search for a cheaper and less allergizing product led to triamcinolone hexacetonide, this procedure being known as "nucleorthesis". The first results at 6 months were encouraging. In 3 centres where triamcinolone hexacetonide was tested with a more than 2 years' follow-up 92 patients could be evaluated. The results obtained were considered satisfactory in 34 patients (36.9 percent), but they were poor in 19 patients (20.6 percent), and 39 patients (42 percent) had to be operated upon within 2 years. Return to surgery took place within the 6 months following nucleorthesis in 18 patients (19.56 percent) and beyond this period in 17 patients (22.8 percent) with degradation of the results. Moreover, calcifications were found in 19 out of 38 patients; they were of varying size, sometimes detected only at computerized tomography, and some of them appeared to produce symptoms. All considered, the failure rates, the number of patients who required surgery and the occurrence of large and sometimes symptomatic calcifications make triamcinolone nucleorthesis unacceptable compared with the recognized percentages of success with papain nucleolysis and surgical operations. For these reasons, we consider that this treatment should be abandoned.
authors: Service de Clinique rhumatologique, Hôpital de La Charité, CHRU, Lille.
authors: B
authors: B
authors: Duquesnoy
authors: F
authors: F
authors: Debiais
authors: A
authors: A
authors: Heuline
authors: E
authors: E
authors: Houvenagel
authors: P
authors: P
authors: Bourgeois
authors: M
authors: M
authors: Alcalay
authors: G
authors: G
authors: Vincent
authors: D
authors: D
authors: Bontoux
authors: M F
authors: MF
authors: Kahn
authors: B
authors: B
authors: Delcambre
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012585:Sciatica / Q000150:complications / Q000601:surgery / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide
vernacular_title: Mauvais résultats de l'injection intradiscale de l'hexacétonide de triamcinolone dans le traitement des sciatiques par hernie discale.