Long-term Clinical Effects of DiscoGel for Cervical Disc Herniation

Abstract

Background: Radiopaque gelified ethanol (RGE; DiscoGel®, Gelscom SAS, France) is used as a chemonucleolysis substance in treating intradiscal herniation, showing good results without complications. It has also been used in cervical disc herniations (CDHs), demonstrating the potential efficacy of this substance. Objective: The aim of the study is to investigate the long-term effectiveness and safety of DiscoGel® in patients with CDH and chronic neck pain. Study Design: This is a cross-sectional, single-center study. Setting: The study was conducted from November 2013 to May 2016 on patients visiting Sakarya University Training and Research Hospital’s pain clinic . Methods: Each patient was evaluated before the procedure (baseline) and at 1, 3, 6, and 12 months after the procedure, using the visual analog scale (VAS) score for pain, the Oswestry Disability Index score to measure degree of disability, and estimate quality of life for those with pain; this coincides with scores on the Neuropathic Pain Questionnaire (DN4) for differential diagnoses. Results: Thirty-three patients with CDH underwent the same treatment with DiscoGel® between November 2013 and May 2016. Significant pain relief was noted, as opposed to preoperative pain, at 1, 3, 6, and 12 months after the procedure according to each patient’s self-evaluation (P = 0.01). Differences in VAS, ODI, and DN4 scores between 1, 3, 6, and 12 months with the same variables were not statistically significant. There were no complications with the procedure. Limitations: Our study was conducted retrospectively, which led to problems with long-term follow-up data. In addition, this study was performed with a small group of patients. Conclusions: RGE is a potential alternative to surgery for patients with pain at the cervical level. However, we concluded that more studies with longer follow-up intervals with RGE will be necessary for assessment of the technique’s efficiency. Key words: Cervical pain, herniation, neuropathic pain, injection, DiscoGel®, chemonucleolysis