Dissertation committee:
Αλέξης Κελέκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Κελέκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παναγιώτης Παπαγγελόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτρης Φιλιππιάδης, Αν. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευθυμία Αλεξοπούλου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ολυμπία Παπακωνσταντίνου, Αν. Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Βελονάκης, Επ. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Purpose is to retrospectively compare efficacy and safety between intradiscal injection of
a Gelified ethanol product and tubular discectomy in the treatment of intervertebral disk herniation.
A bi-central institutional database research identified forty (40) patients suffering from symptomatic
contained disc herniation. Nucleolysis group included 20 patients [mean 50.05±9.27 years-of-age
(male/female 14/6-70/30%)]; Surgery Group included 20 patients [mean 48.45±14.53 years-of-age,
(male/female 12/8-60/40%). Primary outcome was overall 12-month improvement over baseline in
leg pain (NVS units). Procedural technical outcomes were recorded, and adverse events were evaluated
at all follow-up intervals. CIRSE classification system was used for complications’ reporting.
Mean pre-operative pain score in Nucleolysis Group was 7.95±0.94 reduced to 1.25±1.11 at month 1
and 0.45±0.75 NVS units at year 1. Mean pre-operative pain score in Surgery Group was 7.65±1.13
reduced to 1.55±1.79 at month 1 and 0.70±1.38 NVS units at year 1. Pain decrease was statistically
significant after both procedures (p<0.001). There was no statistically significant difference between
pain reduction in both groups (p=0.347). The decrease differences of the pain effect upon general
activities, sleeping, socializing, walking, and enjoying life in the follow-up period between the two
groups were not statistically significant. No complications were noted in both groups. Our limited
data suggest that intradiscal injection of a Gelified ethanol and tubular discectomy are equally effective
on terms of efficacy and safety for the treatment of symptomatic lumbar intervertebral disc herniation
regarding the 12-month mean leg pain improvement. Both achieved similar rapid significant
clinical improvement persisting throughout follow-up period.
Keywords:
Pain, Intervertebral disc, Herniation, Tubular, Discectomy, Injection, Alcohol
