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[PMID]:28526154
[Au] Autor:Bhangare KP; Kaye AD; Knezevic NN; Candido KD; Urman RD
[Ad] Endereço:Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
[Ti] Título:An Analysis of New Approaches and Drug Formulations for Treatment of Chronic Low Back Pain.
[So] Source:Anesthesiol Clin;35(2):341-350, 2017 Jun.
[Is] ISSN:1932-2275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The prevalence of chronic low back pain (CLBP) is increasing. Treatment is effective in less than 50% of patients after 1 year. This review investigates new treatments for CLBP. An extensive literature review focuses on new treatments for CLBP. Their safety and efficacy were evaluated and are described in detail in this review. The investigation identified new treatments for CLBP including chemonucleolysis, platelet-rich plasma injections, artemin, tanezumab, and stem cells. Further research and innovation are needed to implement these methods into practice and assess clinical significance. The current evidence suggests that there are promising new agents for the treatment of CLBP.
[Mh] Termos MeSH primário: Dor Crônica/terapia
Quimiólise do Disco Intervertebral/métodos
Dor Lombar/terapia
[Mh] Termos MeSH secundário: Anticorpos Monoclonais Humanizados/uso terapêutico
Composição de Medicamentos
Seres Humanos
Plasma Rico em Plaquetas
Transplante de Células-Tronco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); EQL0E9GCX1 (tanezumab)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE


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[PMID]:27485047
[Au] Autor:Muto M; Giurazza F; Silva RP; Guarnieri G
[Ad] Endereço:Cardarelli Hospital, Neuroradiology Department, Naples, Italy.
[Ti] Título:Rational approach, technique and selection criteria treating lumbar disk herniations by oxygen-ozone therapy.
[So] Source:Interv Neuroradiol;22(6):736-740, 2016 Dec.
[Is] ISSN:2385-2011
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Radicular lumbar back pain is an important public health problem not yet benefiting from a unequivocal treatment approach. Medical and physical therapies represent the first solution; however, when these fail, the second therapeutic step is still controversial and mini-invasive treatments may play an important role. In these cases oxygen-ozone therapy has been proved to be a very safe and effective option that is widely used with different modalities. This paper, by reviewing oxygen-ozone therapy literature data, aims to describe the rationale of oxygen-ozone therapy for the treatment of lumbar disk herniations, propose an effective procedural technique and clarify patient selection criteria; furthermore, complications and follow-up management are also considered.
[Mh] Termos MeSH primário: Quimiólise do Disco Intervertebral/métodos
Deslocamento do Disco Intervertebral/terapia
Vértebras Lombares
Oxigênio/uso terapêutico
Ozônio/uso terapêutico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Quimiólise do Disco Intervertebral/efeitos adversos
Dor Lombar/etiologia
Dor Lombar/terapia
Masculino
Meia-Idade
Oxigênio/efeitos adversos
Ozônio/efeitos adversos
Seleção de Pacientes
Cirurgia Assistida por Computador
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
66H7ZZK23N (Ozone); S88TT14065 (Oxygen)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170827
[Lr] Data última revisão:
170827
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE


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[PMID]:27247937
[Au] Autor:Fusellier M; Colombier P; Lesoeur J; Youl S; Madec S; Gauthier O; Hamel O; Guicheux J; Clouet J
[Ad] Endereço:Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS 791, Laboratoire d'Ingénierie Ostéo-Articulaire et Dentaire (LIOAD), Group STEP "Skeletal Tissue Engineering and Physiopathology", School of Dental Surgery, 44042 Nantes, France; Department of Diagnostic Imaging, CRIP, National
[Ti] Título:Longitudinal Comparison of Enzyme- and Laser-Treated Intervertebral Disc by MRI, X-Ray, and Histological Analyses Reveals Discrepancies in the Progression of Disc Degeneration: A Rabbit Study.
[So] Source:Biomed Res Int;2016:5498271, 2016.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Regenerative medicine is considered an attractive prospect for the treatment of intervertebral disc (IVD) degeneration. To assess the efficacy of the regenerative approach, animal models of IVD degeneration are needed. Among these animal models, chemonucleolysis based on the enzymatic degradation of the Nucleus Pulposus (NP) is often used, but this technique remains far from the natural physiopathological process of IVD degeneration. Recently, we developed an innovative animal model of IVD degeneration based on the use of a laser beam. In the present study, this laser model was compared with the chemonucleolysis model in a longitudinal study in rabbits. The effects of the treatments were studied by MRI (T2-weighted signal intensity (T2wsi)), radiography (IVD height index), and histology (NP area and Boos' scoring). The results showed that both treatments induced a degeneration of the IVD with a decrease in IVD height and T2wsi as well as NP area and an increase in Boos' scoring. The enzyme treatment leads to a rapid and acute process of IVD degeneration. Conversely, laser radiation induced more progressive and less pronounced degeneration. It can be concluded that laser treatment provides an instrumental in vivo model of slowly evolving IVD degenerative disease that can be of preclinical relevance for assessing new prophylactic biological treatments of disc degeneration.
[Mh] Termos MeSH primário: Quimiólise do Disco Intervertebral/métodos
Degeneração do Disco Intervertebral/patologia
Degeneração do Disco Intervertebral/terapia
Núcleo Pulposo/patologia
Núcleo Pulposo/transplante
[Mh] Termos MeSH secundário: Animais
Modelos Animais de Doenças
Progressão da Doença
Feminino
Lasers
Estudos Longitudinais
Imagem por Ressonância Magnética/métodos
Coelhos
Regeneração/fisiologia
Raios X
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170213
[Lr] Data última revisão:
170213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160602
[St] Status:MEDLINE
[do] DOI:10.1155/2016/5498271


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[PMID]:26676838
[Au] Autor:Perri M; Marsecano C; Varrassi M; Giordano AV; Splendiani A; di Cesare E; Masciocchi C; Gallucci M
[Ad] Endereço:S Salvatore Hospital, Coppito, 67100, L'Aquila, Italy. marco-perri@tiscali.it.
[Ti] Título:Indications and efficacy of O2-O3 intradiscal versus steroid intraforaminal injection in different types of disco vertebral pathologies: a prospective randomized double-blind trial with 517 patients.
[So] Source:Radiol Med;121(6):463-71, 2016 Jun.
[Is] ISSN:1826-6983
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to prospectively evaluate the clinical efficacy of perigangliar steroid and local anesthetic with intradiscal O2-O3 injection versus steroid and local anesthetic intraforaminal injection in different types of herniation and grade of disc degeneration. MATERIALS AND METHODS: A total of 517 patients were randomly assigned to two groups. Control Group (159 men, 101 women; age range 25-89 years) underwent steroid and local anesthetic intraforaminal injection. Study Group (163 men, 94 women; age range 22-92 years) underwent the same treatment with addiction of O2-O3 intradiscal injection. Procedures were performed under computed tomographic guidance. Visual Analog Scale Questionnaire was administered before treatment and at intervals, the last at 6-month follow-up. Results were compared with Kruskal-Wallis and t test. RESULTS: After 6 months, O2-O3 discolysis was successful in 106 (41.24 %) Study Group patients with extrusions compared with 9 Control Group patients (3.5 %) (P < 0.001). In 89 (34.6 %) Study Group patients with protrusions, success rate was statistically significant compared with 5 Control Group patients (1.9 %). Significant difference was detected in the presence of Grade I, II, III of Degenerated Disc in 185 of Study Group patients (68.4 %) compared with 4 Control Group patients (1.5 %). CONCLUSIONS: The addition of O2-O3 discolysis is more effective at 6 months than perigangliar steroid and local anesthetic injection, especially in cases of herniated or protruded discs and with a Grade of Disc Degeneration from mild to moderate range.
[Mh] Termos MeSH primário: Glucocorticoides/uso terapêutico
Quimiólise do Disco Intervertebral/métodos
Deslocamento do Disco Intervertebral/terapia
Oxigênio/uso terapêutico
Ozônio/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Método Duplo-Cego
Feminino
Seres Humanos
Injeções Intralesionais
Masculino
Meia-Idade
Estudos Prospectivos
Radiografia Intervencionista
Inquéritos e Questionários
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Glucocorticoids); 66H7ZZK23N (Ozone); S88TT14065 (Oxygen)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151218
[St] Status:MEDLINE
[do] DOI:10.1007/s11547-015-0598-x


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[PMID]:26215088
[Au] Autor:Léglise A; Lombard J; Moufid A
[Ad] Endereço:Service de chirurgie orthopédique et traumatologique, CHU La Milétrie, 2, rue de La Milétrie, 86000 Poitiers, France. Electronic address: amelie.leglise@orange.fr.
[Ti] Título:DiscoGel® in patients with discal lumbosciatica. Retrospective results in 25 consecutive patients.
[So] Source:Orthop Traumatol Surg Res;101(5):623-6, 2015 Sep.
[Is] ISSN:1877-0568
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo: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.
[Mh] Termos MeSH primário: Géis
Quimiólise do Disco Intervertebral/instrumentação
Dor Lombar/terapia
Vértebras Lombares
Ciática/terapia
[Mh] Termos MeSH secundário: Adulto
Etanol/administração & dosagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Satisfação do Paciente
Estudos Retrospectivos
Tungstênio
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Gels); 3K9958V90M (Ethanol); V9306CXO6G (Tungsten)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150910
[Lr] Data última revisão:
150910
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150729
[St] Status:MEDLINE


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[PMID]:25923680
[Au] Autor:Perri M; Grattacaso G; Di Tunno V; Marsecano C; Di Cesare E; Splendiani A; Gallucci M
[Ad] Endereço:Biotechnological and Applied Clinical Sciences Department, University of L'Aquila, Italy.
[Ti] Título:MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2-O3 discolysis.
[So] Source:Neuroradiol J;28(2):198-204, 2015 Apr.
[Is] ISSN:1971-4009
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Evaluate the discal morpho-structural changes as a predictive sign in the clinical outcome after ozone therapy in lumbar disc herniation using the T2-shine through effect in diffusion-weighted imaging (DWI). METHOD: One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; age range, 23-62 years) were included, previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences, and were randomly assigned to two groups. Seventy-seven patients (control group) underwent conservative treatment with intraforaminal injection of steroid and anaesthetic. The remaining 77 patients (study group) underwent the same treatment with the addition of oxygen-ozone (O2-O3). During the following six months, a MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ² test, Student's t test and analysis of covariance were used for comparison of variables. RESULTS: In the study group, 58 of 77 patients had a successful outcome (responders). In the responders group, DWI T2-shine through effect was present during MRI follow-up and in particular in 53 of 77 patients in six months of follow-up (p < 0.05). Moreover, in the same group a statistically significant disc shrinkage was shown by IDVA in sixth months of follow-up (p < 0.05). CONCLUSIONS: T2-shine through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
[Mh] Termos MeSH primário: Imagem de Difusão por Ressonância Magnética/métodos
Quimiólise do Disco Intervertebral/métodos
Deslocamento do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/terapia
Vértebras Lombares/patologia
Oxigênio/uso terapêutico
Ozônio/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Combinação de Medicamentos
Feminino
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drug Combinations); 66H7ZZK23N (Ozone); S88TT14065 (Oxygen)
[Em] Mês de entrada:1508
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150430
[St] Status:MEDLINE
[do] DOI:10.1177/1971400915576658


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[PMID]:25903710
[Au] Autor:Touraine S; Damiano J; Tran O; Laredo JD
[Ad] Endereço:Radiologie Ostéo-Articulaire, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. sebastien.touraine@lrb.aphp.fr.
[Ti] Título:Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment.
[So] Source:Eur Radiol;25(11):3390-7, 2015 Nov.
[Is] ISSN:1432-1084
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating radicular pain due to disc herniation after failure of conservative treatment. MATERIALS AND METHODS: After failure of conservative treatment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG. RESULTS: Mean pain duration was 6.7 months. Pain intensity decreased by 44% and 62.6% after 1 and 3 months, respectively, versus baseline (P = 0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4%) and 36/42 (85.7%) patients after 1 and 3 months, respectively, and in 31/42 (73.8%) and 33/42 (78.6%) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs. 37.3 years, P = 0.03). None of the other variables studied were significantly associated with pain relief. CONCLUSION: PCEG may significantly improve disc-related radicular pain refractory to conservative treatment. KEY POINTS: • Percutaneous chemonucleolysis using ethanol gel (PCEG) is feasible on an outpatient basis. • PCEG improves disc-related radicular pain refractory to conservative treatment. • PCEG is feasible on an outpatient basis. • Failure of PCEG does not interfere with subsequent spinal surgery.
[Mh] Termos MeSH primário: Etanol/uso terapêutico
Quimiólise do Disco Intervertebral/métodos
Vértebras Lombares
Ciática/terapia
[Mh] Termos MeSH secundário: Adulto
Doença Crônica
Feminino
Géis
Seres Humanos
Deslocamento do Disco Intervertebral/complicações
Deslocamento do Disco Intervertebral/terapia
Dor Lombar/etiologia
Dor Lombar/terapia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Medição da Dor
Estudos Prospectivos
Estenose Espinal/complicações
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Gels); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150424
[St] Status:MEDLINE
[do] DOI:10.1007/s00330-015-3740-1


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[PMID]:25743238
[Au] Autor:Perri M; Grattacaso G; di Tunno V; Marsecano C; Gennarelli A; Michelini G; Splendiani A; Di Cesare E; Masciocchi C; Gallucci M
[Ad] Endereço:Department of Biotechnological and Applied Clinical Sciences, Division of Radiology, University of L'Aquila, 67100, L'Aquila, Italy. marco-perri@tiscali.it.
[Ti] Título:T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen-ozone discolysis: a randomized, double-blind trial with steroid and O2-O3 discolysis versus steroid only.
[So] Source:Radiol Med;120(10):941-50, 2015 Oct.
[Is] ISSN:1826-6983
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the discal morpho-structural changes as predictive sign in the clinical outcome after Ozone Therapy in lumbar disc herniation using the T2 shine-through effect in DWI. METHODS: One hundred and fifty-four patients suffering from lumbosciatica (89 men and 65 women; range 23-62 years) were included in previous MR study performed with FSE-T2 and T2-fat, SE-T1 and DWI sequences and were randomly assigned to two groups. Seventy-seven patients (Control Group) underwent conservative treatment with intraforaminal injection of steroid and anesthetic. The remaining 77 patients (Study Group) underwent the same treatment with the addiction of oxygen-ozone (O2-O3). During the coming 6 months, an MRI follow-up with the same sequences was performed. An intervertebral disc volumetric analysis (IDVA), DWI signal score and post treatment clinical outcome evaluation were performed for an assessment of hernia reduction. χ (2) test, Student's t test and analysis of covariance were used for comparison of variables. RESULTS: In the Study Group, 58 over 77 patients had a successful outcome (Responders). In the Responders group, DWI T2 shine-through effect was present during MRI follow-up and in particular in 53 of 77 patients in the 6 months of follow-up (P < 0.05). Moreover, in the same group was present a statistically significant discs' shrinkage in the sixth month of follow-up (P < 0.05) as showed by IDVA. CONCLUSIONS: T2 shine-through effect in DWI is present before morphological disc reduction and moreover could be considered as a predictive sign of response to oxygen-ozone treatment.
[Mh] Termos MeSH primário: Betametasona/uso terapêutico
Imagem de Difusão por Ressonância Magnética
Glucocorticoides/uso terapêutico
Quimiólise do Disco Intervertebral
Deslocamento do Disco Intervertebral/terapia
Disco Intervertebral/patologia
Vértebras Lombares/patologia
Oxigênio/uso terapêutico
Ozônio/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Glucocorticoids); 66H7ZZK23N (Ozone); 9842X06Q6M (Betamethasone); S88TT14065 (Oxygen)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150307
[St] Status:MEDLINE
[do] DOI:10.1007/s11547-015-0519-z


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[PMID]:25395657
[Au] Autor:Bellini M; Romano DG; Leonini S; Grazzini I; Tabano C; Ferrara M; Piu P; Monti L; Cerase A
[Ad] Endereço:From the Neuroimaging and Neurointerventional Unit - NINT (M.B., D.G.R., S.L., M.F., L.M., A.C.) matteo.bellini@icloud.com.
[Ti] Título:Percutaneous injection of radiopaque gelified ethanol for the treatment of lumbar and cervical intervertebral disk herniations: experience and clinical outcome in 80 patients.
[So] Source:AJNR Am J Neuroradiol;36(3):600-5, 2015 Mar.
[Is] ISSN:1936-959X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Chemonucleolysis represents a minimally invasive percutaneous technique characterized by an intradiskal injection of materials under fluoroscopic or CT guidance. Recently, a substance based on radiopaque gelified ethanol has been introduced. The purpose of this study was to describe the indications, procedure, safety, and efficacy of radiopaque gelified ethanol in the percutaneous treatment of cervical and lumbar disk herniations. MATERIALS AND METHODS: Between September 2010 and August 2013, 80 patients (32 women and 48 men; age range, 18-75 years) were treated for 107 lumbar disk herniations (L2-L3, n = 1; L3-L4, n = 15; L4-L5, n = 53; and L5-S1, n = 38) and 9 cervical disk herniations (C4-C5, n = 2; C5-C6, n = 2; C6-C7, n = 3; and C7-D1, n = 2) by percutaneous intradiskal injection of radiopaque gelified ethanol under fluoroscopic guidance. Thirty-six patients underwent a simultaneous treatment of 2 disk herniations. Patient symptoms were resistant to conservative therapy, with little or no pain relief after 4-6 weeks of physical therapy and drugs. All patients were evaluated by the Visual Analog Scale and the Oswestry Disability Index. RESULTS: Sixty-two of 73 (85%) patients with lumbar disk herniations and 6/7 (83%) patients with cervical disk herniations obtained significant symptom improvement, with a Visual Analog Scale reduction of at least 4 points and an Oswestry Disability Index reduction of at least 40%. Leakage of radiopaque gelified ethanol in the surrounding tissues occurred in 19 patients, however without any clinical side effects. CONCLUSIONS: In our experience, percutaneous intradiskal injection of radiopaque gelified ethanol is safe and effective in reducing the period of recovery from disabling symptoms.
[Mh] Termos MeSH primário: Depressores do Sistema Nervoso Central/administração & dosagem
Depressores do Sistema Nervoso Central/uso terapêutico
Etanol/administração & dosagem
Etanol/uso terapêutico
Géis/uso terapêutico
Quimiólise do Disco Intervertebral/métodos
Deslocamento do Disco Intervertebral/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Cutânea
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Géis/administração & dosagem
Seres Humanos
Injeções/métodos
Disco Intervertebral/diagnóstico por imagem
Masculino
Meia-Idade
Medição da Dor
Radiografia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Central Nervous System Depressants); 0 (Gels); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141115
[St] Status:MEDLINE
[do] DOI:10.3174/ajnr.A4166


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[PMID]:25363257
[Au] Autor:Dall'Olio M; Princiotta C; Cirillo L; Budai C; de Santis F; Bartolini S; Serchi E; Leonardi M
[Ad] Endereço:Neuroradiology Unit, IRCCS Institute of Neurological Sciences; Bologna, Italy - mdallolio@gmail.com.
[Ti] Título:Oxygen-ozone therapy for herniated lumbar disc in patients with subacute partial motor weakness due to nerve root compression.
[So] Source:Interv Neuroradiol;20(5):547-54, 2014 Oct 31.
[Is] ISSN:1591-0199
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intradiscal oxygen-ozone (O2-O3) chemonucleolysis is a well-known effective treatment for pain caused by protruding disc disease and nerve root compression due to bulging or herniated disc. The most widely used therapeutic combination is intradiscal injection of an O2-O3 mixture (chemonucleolysis), followed by periradicular injection of O2-O3, steroid and local anaesthetic to enhance the anti-inflammatory and analgesic effect. The treatment is designed to resolve pain and is administered to patients without motor weakness, whereas patients with acute paralysis caused by nerve root compression undergo surgery 24-48h after the onset of neurological deficit. This paper reports on the efficacy of O2-O3 chemonucleolysis associated with anti-inflammatory foraminal injection in 13 patients with low back pain and cruralgia, low back pain and sciatica and subacute partial motor weakness caused by nerve root compression unresponsive to medical treatment. All patients were managed in conjunction with our colleagues in the Neurosurgery Unit of Bellaria Hospital and the IRCCS Institute of Neurological Sciences, Bologna. The outcomes obtained are promising: 100% patients had a resolution of motor weakness, while 84.6% had complete pain relief. Our results demonstrate that O2-O3 therapy can be considered a valid treatment option for this category of patients.
[Mh] Termos MeSH primário: Quimiólise do Disco Intervertebral/métodos
Deslocamento do Disco Intervertebral/tratamento farmacológico
Região Lombossacral
Debilidade Muscular/etiologia
Oxigênio/administração & dosagem
Oxigênio/uso terapêutico
Ozônio/administração & dosagem
Ozônio/uso terapêutico
Compressão da Medula Espinal/complicações
Raízes Nervosas Espinhais
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Anestesia Local
Anti-Inflamatórios/uso terapêutico
Feminino
Seres Humanos
Dor Lombar/etiologia
Dor Lombar/terapia
Masculino
Metilprednisolona/uso terapêutico
Meia-Idade
Seleção de Pacientes
Compressão da Medula Espinal/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 66H7ZZK23N (Ozone); S88TT14065 (Oxygen); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141104
[St] Status:MEDLINE
[do] DOI:10.15274/INR-2014-10078



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