Department of Neurosurgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid 22110, Jordan.
Emirates Specialty Hospital, Dubai Healthcare City, P.O. Box 66566, Dubai, UAE.
Biomed Res Int. 2019 Mar 13;2019:2193436. doi: 10.1155/2019/2193436. eCollection 2019.
Percutaneous DiscoGel® (Gelscom SAS, France), introduced in 2007 as a promising new minimal invasive technique, showed efficacy and safety in lumbar spine surgery, with limited use and scientific reports with regard to the cervical spine. Since the first publication of its use on the cervical spine (2010), less than 100 cases have been published. We introduce an initial experience with this relatively new procedure. We hypothesized that percutaneous DiscoGel® is a safe and effective option for chronic neck pain of cervical discogenic origin.
This was a clinical study on 10 patients with chronic discogenic pain operated on for 18 cervical discs with percutaneous DiscoGel®. Inclusion criteria were patients with chronic axial or referred neck pain with MRI showing a cervical disc that is consistent with patient symptoms and failed conservative treatment. Exclusion criteria were clinical myelopathy, motor deficit, severe stenosis or reduced disc height by more than 50%, or previous cervical spine surgery.
A total of 10 cases consisting of 6 females and 4 males underwent treatment with percutaneous DiscoGel® for 18 cervical discs. C5/C6 was the most affected level. The mean preoperative VAS score was 8; the postoperative VAS scores at 6 weeks and 3 months were 2.2 and 2.9, respectively. There were no postoperative complications or neurological deficits.
The present study has the limitation of the small number of cases; however, with the limited number of studies and less than 100 published cases in the literature, this initial work shows that cervical percutaneous DiscoGel® is an effective minimally invasive bridging option between conservative and open surgical treatment for cervical discogenic pain, with a high success rate. The differentiation of pain types (nociceptive, referred, radicular, and trapezius myalgia) that can coexist is crucial for procedure selection and improving treatment outcome.
Percutaneous DiscoGel®（法国 Gelscom SAS）于 2007 年作为一种有前途的微创新技术推出，已在腰椎手术中显示出疗效和安全性，但在颈椎方面的应用有限，相关科学报告也较少。自 2010 年首次报道其在颈椎上的应用以来，发表的病例不到 100 例。我们介绍了该相对较新手术的初步经验。我们假设经皮 DiscoGel®是治疗颈椎间盘源性慢性颈痛的一种安全有效的选择。
这是一项对 10 例接受经皮 DiscoGel®治疗的 18 个颈椎间盘源性慢性疼痛患者的临床研究。纳入标准为慢性轴性或放射性颈痛患者，MRI 显示颈椎间盘与患者症状一致，且保守治疗无效。排除标准为临床颈椎病、运动障碍、严重狭窄或椎间盘高度减少 50%以上，或以前有颈椎手术史。
共 10 例，包括 6 例女性和 4 例男性，接受经皮 DiscoGel®治疗 18 个颈椎间盘。C5/C6 是最常受累的节段。术前 VAS 评分为 8 分，术后 6 周和 3 个月时的 VAS 评分分别为 2.2 和 2.9 分。无术后并发症或神经功能缺损。
本研究病例数量有限，但在有限的研究和文献中不到 100 例的报道的情况下，这项初步工作表明，颈椎经皮 DiscoGel®是一种有效的微创桥接选择，可在颈椎间盘源性疼痛的保守和开放手术治疗之间进行，成功率高。疼痛类型（伤害性、放射性、神经根性和斜方肌肌痛）的区分对于手术选择和提高治疗效果至关重要。
