Percutaneous treatment of degenerative disc disease with radiopaque gelified ethanol (Discogel); Initial experience in Shiraz, Southern Iran

Minimally-invasive treatments of degenerative disc disease are becoming more popular. Various intradiscal procedures have been introduced since many years ago, with variable and inconsistent outcome. Chemical neucleolysis has been performed using multiple chemical substances including Chymopapain and alcohol with limited success. Discogel, a new similar substance composed of ethanol mixed with methycellulose and radiopaque material, has been recently introduced with promising results. In this study, we try to present our initial experience with intradiscal injection of Discogel in Iranian patients, to evaluate its efficacy and safety. Methods: Since August 2014, we have started our experience with Discogel in Shiraz. Patients with symptomatic lumbar or cervical disc herniation who failed conservative non-surgical treatment, were included into the study. The herniated disc needed to be contained (either unruptured or ruptured, but not calcified), disc height more than 50% of the initial height, Pfirrman grading of III or IV, with radicular symptoms more prominent than axial symptoms. 0.4 to 1 milliliter of Discogel was injected under controlled fluoroscopic guidance using standardized techniques. Results: Our results indicate a more than 87% of significant long-lasting decrease in pain with limited functional disability. No complications were noted. Conclusion: This preliminary study shows efficacy and safety of Discogel intradiscal injection in selected cases. Further randomized studies are needed to verify the effect of this technique.