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Percutaneous Treatment Of Lumbar And Cervical Intervertebral Disc Herniations With Radiopaque Gelified Ethanol (Rge): Clinical And Morphostructural Changes In Our Experience 2014

Category Interventional Matteo Bellini, MD Daniele Giuseppe Romano, MD Sara Leonini, MD Irene Grazzini, MD Lucia Monti, MD Sandra Bracco, MD Alfonso Cerase Purpose To assess safety and efficacy of RGE in the percutaneous treatment of lumbar and cervical disc herniations. Materials & Methods Between September 2010 and February 2013, 61 patients (22 females and 39 males, age range: 18-75 years) were treated for 80 lumbar disc herniations (L2-L3: 1, L3-L4: 11, L4-L5: 38, and L5-S1: 30) and 8 cervical disc herniations (C4-C5: 2, C5-C6: 2, C6-C7: 3, and C7-D1: 1) by percutaneous intradiscal injection of RGE (DISCOGEL, Gelscom SAS, Caen, France). All the treatments were performed under fluoroscopic guidance with biplanar 3D rotational angiographic system using 18G needle for lumbar and 21G for cervical discs. All the patients received local anesthesia and a “short-term” antibiotic therapy. In 27 patients, the treatment was performed in 2 levels in the same session. In 7 cases large extruded and migrated herniations have been treated. All patients underwent clinical evaluation, including VAS scale before treatment, soon after treatment, 3 and 6 months later. Low-dose 3D-CT was obtained after treatment and 3 months later. Results All the procedures have been well tolerated. There were no allergic complications. 47 out of 55 patients (85%) with lumbar disc herniations and 5 of 6 patients with cervical herniations obtained improvement in symptoms. In these patients, VAS scale showed a significant score reduction (p Conclusion These results show the efficacy and innocuity of RGE. RGE does not produce any intervertebral disc morphostructural change. References Theron J, Guimaraens L, Casasco A, Sola T, Cuellar H, Courtheoux P (2007) Percutaneous treatment of lumbar intervertebral disk hernias with radiopaque gelified ethanol: a preliminary study. J Spinal Disord Tech. 20:526-32 Theron J, Cuellar H, Sola T, Guimaraens L, Casasco A, Courtheoux P (2010) Percutaneous treatment of cervical disk hernias using gelified ethanol. AJNR Am J Neuroradiol. 31:1454-6. Guarnieri G, De Dominicis G, Muto M (2010) Intradiscal and Intramuscular Injection of Discogel® - Radiopaque Gelified Ethanol: Pathological Evaluation. The Neuroradiology Journal 23: 249-252