title: A minimally invasive treatment for lumbar disc herniation: DiscoGel® chemonucleolysis in patients unresponsive to chemonucleolysis with oxygen-ozone.
abstract: 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. O₂-O₃ chemonucleolysis (O₂-O₃ 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 O₂-O₃ 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 O₂-O₃ 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.
authors.affiliation: Department of Neuroradiology, IRCCS delle Scienze Neurologiche, Ospedale Bellaria, University of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stagni
authors.forename: F
authors.initials: F
authors.lastname: de Santis
authors.forename: L
authors.initials: L
authors.lastname: Cirillo
authors.forename: M
authors.initials: M
authors.lastname: Dall'olio
authors.forename: C
authors.initials: C
authors.lastname: Princiotta
authors.forename: L
authors.initials: L
authors.lastname: Simonetti
authors.forename: A
authors.initials: A
authors.lastname: Stafa
authors.forename: M
authors.initials: M
authors.lastname: Leonardi
mesh_terms: D000328:Adult; D000368:Aged; D004351:Drug Resistance; D000431:Ethanol / Q000627:therapeutic use*; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000628:therapy*; D008159:Lumbar Vertebrae; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009339:Needles; D010100:Oxygen / Q000008:administration & dosage; D010126:Ozone / Q000008:administration & dosage; D011859:Radiography; D012997:Solvents / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005782:Gels; D012997:Solvents; D000431:Ethanol; D010126:Ozone; D010100:Oxygen