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Effectiveness of intradiscal injection of radiopaque gelified ethanol (DiscoGel®) versus percutaneous laser disc decompression in patients with chronic radicular low back pain

Korean Journal of Pain 2020년 33권 1호 p.66 ~ 72
 ( Hashemi Masoud ) - Shahid Beheshti University of Medical Sciences Anesthesiology Research Center

 ( Dadkhah Payman ) - Shahid Beheshti University of Medical Sciences Anesthesiology Research Center
 ( Taheri Mehrdad ) - Shahid Beheshti University of Medical Sciences Anesthesiology Research Center
 ( Katibeh Pegah ) - Shiraz University of Medical Sciences Department of Pediatric Neurology
 ( Asadi Saman ) - Shahid Beheshti University of Medical Sciences Anesthesiology Research Center

Abstract


Background: Low back pain secondary to discopathy is a common pain disorder. Multiple minimally invasive therapeutic modalities have been proposed; however, to date no study has compared percutaneous laser disc decompression (PLDD) with intradiscal injection of radiopaque gelified ethanol (DiscoGel®). We are introducing the first study on patient-reported outcomes of DiscoGel®vs. PLDD for radiculopathy.

Methods: Seventy-two patients were randomly selected from either a previous strategy of PLDD or DiscoGel®, which had been performed in our center during 2016?2017. Participants were asked about their numeric rating scale (NRS) scores, Oswestry disability index (ODI) scores, and progression to secondary treatment.

Results: The mean NRS scores in the total cohort before intervention was 8.0, and was reduced to 4.3 in the DiscoGel® group and 4.2 in the PLDD group after 12 months, which was statistically significant. The mean ODI score before intervention was 81.25% which was reduced to 41.14% in the DiscoGel® group and 52.86% in the PLDD group after 12 months, which was statistically significant. Between-group comparison of NRS scores after two follow-ups were not statistically different (P = 0.62) but the ODI score in DiscoGel® was statistically lower (P = 0.001). Six cases (16.67%) from each group reported undergoing surgery after the follow-up period which was not statistically different.

Conclusions: Both techniques were equivalent in pain reduction but DiscoGel® had a greater effect on decreasing disability after 12 months, although the rate of progression to secondary treatments and/or surgery was almost equal in the two groups.

키워드

Chronic Pain; Disability Evaluation; Discectomy; Intervertebral Disc; Low Back Pain; Pain Management; Radiculopathy; Visual Analog Scale
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