A Léglise1, J Lombard2, A Moufid3. 1. Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France. Electronic address: amelie.leglise@orange.fr. 2. Service de chirurgie orthopédique et traumatologique, centre hospitalier Georges-Renon, 40, avenue Charles-de-Gaulle, 7900 Niort, France. 3. Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France.
Abstract
INTRODUCTION: Discogenic lumbosciatica is a common disorder in patients between 30 and 40 years old. Because of the frequency and socio-professional impact of this entity, it represents a real public health problem. DiscoGel® is a class III medical device used for nucleolysis to avoid discectomy. The goal of this study was to evaluate the effectiveness of this treatment in patients with discogenic lumbosciatica following unsuccessful conservative medical treatment. MATERIALS AND METHODS: This is a retrospective, single-center study including 25 patients who were treated with DiscoGel® between 2010 and 2011 at Niort Hospital, France. The severity of lumbar and radicular pain was assessed by a verbal numeric scale (VNS) and patient satisfaction. Patients were classified as successes or failures. RESULTS: Treatment was found to reduce the severity of lumbar pain in 73% and of radicular pain in 80% of patients in the success group. Treatment was a failure in 64% of patients. A comparison of the two groups showed that a preoperative MODIC 2 MRI signal of the adjacent vertebral end plate was significantly associated with treatment failure (Chi(2)=8572, P < 0.01). DISCUSSION: The VNS for lumbar pain and radicular pain decreased in 42% and 50% of patients respectively after the use of DiscoGel®. In our series, DiscoGel® treatment was unsuccessful for discogenic lumbosciatica in 16 patients. These results do not support others in the literature. A lack of statistical power could partly explain these results. The most important result of this study is found in the subgroup analysis which suggests that indications for DiscoGel® treatment could be modified in the future in relation to preoperative imaging data. LEVEL OF EVIDENCE: 4.
INTRODUCTION: Discogenic lumbosciatica is a common disorder in patients between 30 and 40 years old. Because of the frequency and socio-professional impact of this entity, it represents a real public health problem. DiscoGel® is a class III medical device used for nucleolysis to avoid discectomy. The goal of this study was to evaluate the effectiveness of this treatment in patients with discogenic lumbosciatica following unsuccessful conservative medical treatment. MATERIALS AND METHODS: This is a retrospective, single-center study including 25 patients who were treated with DiscoGel® between 2010 and 2011 at Niort Hospital, France. The severity of lumbar and radicular pain was assessed by a verbal numeric scale (VNS) and patient satisfaction. Patients were classified as successes or failures. RESULTS: Treatment was found to reduce the severity of lumbar pain in 73% and of radicular pain in 80% of patients in the success group. Treatment was a failure in 64% of patients. A comparison of the two groups showed that a preoperative MODIC 2 MRI signal of the adjacent vertebral end plate was significantly associated with treatment failure (Chi(2)=8572, P < 0.01). DISCUSSION: The VNS for lumbar pain and radicular pain decreased in 42% and 50% of patients respectively after the use of DiscoGel®. In our series, DiscoGel® treatment was unsuccessful for discogenic lumbosciatica in 16 patients. These results do not support others in the literature. A lack of statistical power could partly explain these results. The most important result of this study is found in the subgroup analysis which suggests that indications for DiscoGel® treatment could be modified in the future in relation to preoperative imaging data. LEVEL OF EVIDENCE: 4.