Intradiscal Combination of Pulsed Radiofrequency and Gelified Ethanol for the Treatment of Chronic Discogenic Low Back Pain

Abstract

Dear Editor, Discogenic pain affects approximately 45% of patients suffering from chronic low back pain, and it is caused by chemical and mechanical changes of the intervertebral disc [1]. Many different minimally invasive techniques have been used for the treatment of this condition, with various results. We report the combination of intradiscal pulsed radiofrequency combined to gelified ethanol application for the treatment of chronic discogenic low back pain. Pulsed radiofrequency mechanism of action has been well discussed [2,3]. Gelified ethanol is an implantable medical device in which an opaque agent in X-rays (the tungsten) was added [4,5]. The implant is administered within the affected intervertebral disc's nucleus pulposus, via a fine needle that is guided into the center of the disc, transdermally, under fluoroscopic guidance [4,5]. To our knowledge, this is the first report of the combination of the two methods via the same radiofrequency needle, for the treatment of chronic discogenic low back pain. The patients enrolled suffered from discogenic low back pain, refractory to conservative treatment and physiotherapy for at least 6 months, and reported concordant pain during provocative discography. Pain scores (numeric rating scale 0–10) and satisfaction rates (visual analogue scale 0–10, where 0: “worst” satisfaction and …