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

Purpose: To investigate the efficacy and safety of radi-opaque 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 cate-gorised 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.