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J Spinal Disord Tech · Oct 2007
Clinical TrialPercutaneous treatment of lumbar intervertebral disk hernias with radiopaque gelified ethanol: a preliminary study.
- Jacques Theron, Leopoldo Guimaraens, Alfredo Casasco, Teresa Sola, Hugo Cuellar, and Patrick Courtheoux.
- Department of Neuroradiologie, CHU Côte de Nacre, Avenue de la Côte de Nacre, Caen, France. theronjcq@aol.com
- J Spinal Disord Tech. 2007 Oct 1; 20 (7): 526-32.
Study DesignProspective clinical trial.ObjectiveDemonstrate the safety and efficacy of gelified ethanol in the percutaneous treatment of lumbar disk hernias.Summary Of Background DataAfter 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.MethodsTwo 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.ResultsVery 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.ConclusionsThis preliminary study shows the efficacy and inocuity of this new substance that could take over the Chymopapain therapeutic field.
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