Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment
Purpose To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating ra- dicular pain due to disc herniation after failure of conservative treatment
Materials and methods After failure of conservative treat- ment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG. Results Mean pain duration was 6.7 months. Pain intensity decreased by 44 % and 62.6 % after 1 and 3 months, respec- tively, versus baseline (P=0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4 %) and 36/42 (85.7 %) patients after 1 and 3 months, respectively, and in 31/42 (73.8 %) and 33/42 (78.6 %) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs
۳۷.۳ years, P = 0.03). None of the other variables studied were significantly associated with pain relief.
Conclusion PCEG may significantly improve disc-related ra- dicular pain refractory to conservative treatment
• Percutaneous chemonucleolysis using ethanol gel (PCEG) is
feasible on an outpatient basis
• PCEG improves disc-related radicular pain refractory to
• PCEG is feasible on an outpatient basis.
• Failure of PCEG does not interfere with subsequent spinal
Keywords Radicular pain . Sciatica . Percutaneous chemonucleolysis . Ethanol gel . Disc herniation
Click below link for pdf