Gogos Christos, Filippiadis Dimitrios K, Velonakis Georgios, Kelekis Nikolaos, Papagelopoulos Panayiotis, Kelekis Alexis
Neurosurgery Clinic, General Hospital "Asklepieio", 16673 Athens, Greece.
2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Diagnostics (Basel). 2023 Jun 25;13(13):2164. doi: 10.3390/diagnostics13132164.
The purpose of this study was 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%)] and 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 ( < 0.001). There was no statistically significant difference between pain reduction in both groups ( = 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. Results from the current study report that intradiscal injection of a gelified ethanol and tubular discectomy were 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.
本研究的目的是回顾性比较椎间盘内注射凝胶化乙醇产品与管状椎间盘切除术在治疗椎间盘突出症方面的疗效和安全性。一项双中心机构数据库研究确定了40例有症状的包容性椎间盘突出症患者。溶核组包括20例患者[平均年龄50.05±9.27岁（男/女14/6 - 70/30%）]，手术组包括20例患者[平均年龄48.45±14.53岁，（男/女12/8 - 60/40%）]。主要结局是与基线相比，腿部疼痛在12个月时的总体改善情况（NVS单位）。记录手术技术结果，并在所有随访期间评估不良事件。采用CIRSE分类系统报告并发症。溶核组术前平均疼痛评分为7.95±0.94，在第1个月降至1.25±1.11，在第1年降至0.45±0.75 NVS单位。手术组术前平均疼痛评分为7.65±1.13，在第1个月降至1.55±1.79，在第1年降至0.70±1.38 NVS单位。两种手术后疼痛均有显著下降（<0.001）。两组疼痛减轻情况无统计学显著差异（=0.347）。两组在随访期间对一般活动、睡眠、社交、行走和享受生活的疼痛影响降低差异无统计学意义。两组均未发现并发症。本研究结果表明，就治疗有症状的腰椎间盘突出症的12个月平均腿部疼痛改善情况而言，椎间盘内注射凝胶化乙醇和管状椎间盘切除术在疗效和安全性方面同样有效。两者在整个随访期间均实现了类似的快速显著临床改善。
