Efficacy of DiscoGel in Treatment of Degenerative Disc Disease: A Prospective 1-Year Observation of 67 Patients

Kajetan Latka,Waldemar Kolodziej,Jacek Chowaniec,Miroslaw Latka,Tomasz Olbrycht,Marek Waligora,Dariusz Latka,Stanislaw Hendryk,Klaudia Kozlowska

doi:10.3390/brainsci11111434

Kajetan Latka, Waldemar Kolodziej + Show 7 more

Open Access

https://doi.org/10.3390/brainsci11111434

Copy DOI

Journal: Brain Sciences	Publication Date: Oct 28, 2021
Citations: 5	License type: CC BY 4.0

Affiliation: Opole University, Medical University of Silesia

Abstract

Patients with degenerative disc disease may suffer from chronic lumbar discogenic (DP) or radicular leg (RLP) pain. Minimally invasive DiscoGel therapy involves the percutaneous injection of an ethanol gel into the degenerated disk’s nucleus pulposus. This paper compares the 1-year outcome of such treatment in DP and RLP patients. We operated on 67 patients (49 men and 18 women) aged 20–68 years (mean age 46 ± 11 years) with DP (n = 45) and RLP (n = 22), of at least 6–8 weeks duration, with no adverse effects. We evaluated the treatment outcome with Core Outcome Measures Index (COMI) and Visual Analog Scale (VAS). A year after the ethanol gel injection, in the DP cohort, COMI and VAS dropped by 66% (6.40 vs. 2.20) and 53% (6.33 vs. 2.97), respectively. For the RLP patients, the corresponding values dropped 48% (7.05 vs. 3.68) and 54% (6.77 vs. 3.13). There were no differences between the cohorts in COMI and VAS at the follow-up end. Six months into the study, 74% of DP and 81% of RLP patients did not use any analgesics. Ethanol gel therapy can be effective for many patients. Moreover, its potential failure does not exclude surgical treatment options.

Highlights

Intervertebral discs (IVDs) are indispensable for the normal functioning of the human spine
The IVD consists of the nucleus pulposus (NP), a water-rich gelatinous center that primarily bears pressure; the annulus fibrosus (AF), a fibrous structure of 15–25 concentric sheets of collagen that confines the pressurized NP; and the vertebral end-plates (VEP), which are cartilaginous plates that are interwoven into the AF at the disc-vertebrae interface and supply nutrients to the disc
Advanced IVD degeneration is characterized by disc height loss, osteophyte formation, intranuclear calcification, VEP sclerosis, and AF fissures or tears [2,3]

Summary

Introduction

Intervertebral discs (IVDs) are indispensable for the normal functioning of the human spine. They act as ligaments that hold the adjacent vertebrae together, shock absorbers, and “pivots” allowing the spine to bend, rotate, and twist. The IVD consists of the nucleus pulposus (NP), a water-rich gelatinous center that primarily bears pressure; the annulus fibrosus (AF), a fibrous structure of 15–25 concentric sheets of collagen (lamellae) that confines the pressurized NP; and the vertebral end-plates (VEP), which are cartilaginous plates that are interwoven into the AF at the disc-vertebrae interface and supply nutrients to the disc. Advanced IVD degeneration is characterized by disc height loss, osteophyte formation, intranuclear calcification, VEP sclerosis, and AF fissures or tears [2,3].

Methods

Discussion

Conclusion