Clinical outcome and safety of percutaneous Radiopaque Gelified Ethanol injection in patients with persisting lumbar disc herniation

Stavros Charalambous, Adam Hatzidakis, Konstantinos Spanakis, Andreas Yannopoulos, Despo Ierodiakonou, Apostolos Karantanas


Purpose: To investigate the efficacy and safety of radiopaque gelified ethanol (RGE) injection in patients with medium to large size intervertebral lumbar disc hernias including cases requiring alternative access routes.

Material and Methods: Between December 2014 and June 2018, twenty-five patients (14 males, 11 females, median age 52 years (min 21-max 90 years)), were treated for equal number of intervertebral disc hernias by means of RGE injection under computed tomography (CT)-guidance. All patients were free from neurologic deficits and reported low back pain resistant to conservative treatment for at least six weeks. Pre- and post- treatment pain was evaluated using a visual analogue scale (VAS) score and the VAS difference pre- and post- (6 months) treatment was tested with Wilcoxon matched-pair signed-rank test. Patients were then categorised into groups according to % change in VAS (poor (0%), good (1-99%), excellent (100%) pain response). The association of results with quality of life (QoL) (high vs. low) was assessed using the Fisher’s exact test.

Results: At the end of the 6-month follow up, pain was significantly improved (mean (SD) in VAS was dropped from 8.1 (1.26) to 3.1 (3.10); mean (95% CI) decrease 5.0 (3.6, 6.4) (p<0.001)). Pain response to treatment was excellent in 8 (32%) patients, good in 11 (44%) and poor in 6 (24%) and was significantly associated with the QoL (p<0.001).

Conclusions: Percutaneous CT-guided intradiscal RGE injection is safe, easy to handle and offers good therapeutic outcome with better QoL.


Disc herniation; Percutaneous treatment; Radiopaque gelified ethanol; Computed Tomography/guided treatment; MR imaging/diagnosis

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