Percutaneous treatment of lumbar intervertebral disk hernias with radiopaque gelified ethanol: a preliminary study.
METHODS
Prospective clinical trial.


OBJECTIVE
Demonstrate the safety and efficacy of gelified ethanol in the percutaneous treatment of lumbar disk hernias.


BACKGROUND
After the commercial withdrawal of Chymopapain, the need for new substances to treat intervertebral disk hernias was evident. Good results were obtained with pure ethanol, but this substance was difficult to handle. We decided to use a similar substance mixed with ethylcellulose to increase its viscosity and enhanced with radiopaque material.


METHODS
Two hundred seventy-six consecutive patients sent to be treated of a lumbar intervertebral disk hernia percutaneously were included in this preliminary study and treated with radiopaque gelified ethanol (RGE) and intra-articular steroids. Three groups were set, group A for patients to be treated only with RGE and groups B and C for difficult cases presenting a narrow canal, foraminal hernia, or hiperalgic sleepless hernia, treated with RGE plus another intradiscal technique, automatized percutaneous diskectomy for group B and radiofrequency nucleoplasty for group C.


RESULTS
Very good or good results were obtained in 202 (91.4%) of the 221 patients in group A. Of the 44 patients in group B, 37 patients (84%) presented very good or good results and in 9 (82%) of the 11 patients of group C, we obtained similar results. There was no allergic complication in any of our patients. Short-term follow-up with magnetic resonance showed little or no changes in the intervertebral disk but there was discordance with clinical signs. Long-term follow-up magnetic resonance showed a dramatic reduction in hernia volume.


CONCLUSIONS
This preliminary study shows the efficacy and inocuity of this new substance that could take over the Chymopapain therapeutic field.
Theron
Jacques
J
Department of Neuroradiologie, CHU Côte de Nacre, Avenue de la Côte de Nacre, Caen, France. theronjcq@aol.com
Guimaraens
Leopoldo
L
Casasco
Alfredo
A
Sola
Teresa
T
Cuellar
Hugo
H
Courtheoux
Patrick
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002482:Cellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003287:Contrast Media; D017587:Diskectomy, Percutaneous; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D016896:Treatment Outcome
D003287:Contrast Media; D012597:Sclerosing Solutions; D000431:Ethanol; C013517:ethyl cellulose; D002482:Cellulose