Article

Sciatica is a common disease; between 13% and 40% of the general
population will experience at least one episode of sciatica due to spinal disc
herniation and nerve root irritation. In some specialist centres, percutaneous
intradiscal techniques can be applied as an intermediate measure between
conservative treatment and surgery, with a view to avoiding the adverse events
associated with surgical discectomy. Discogel((R)) is a percutaneously implanted
medical device for the treatment of lumbar sciatica due to a herniated disc. We performed an open, prospective, observational study in order to (a) determine
whether the prior use of air disc manometry could limit the risk of nerve root
irritation reportedly associated with nucleolysis and administration of
Discogel((R)) and (b) investigate the technique's efficacy and safety. METHOD: A
total of 79 Discogel((R))-treated patients were systematically reviewed. A nurse
anaesthetist evaluated each patient's pain levels during the procedure itself.
The therapist assessed the patient on inclusion and 8weeks after the
Discogel((R)) procedure. A third assessment was based on a telephone interview
(by an independent assessor) at least 4months after the procedure. RESULTS: Pain
levels immediately after the Discogel((R)) procedure (1.7+/-2.0) were markedly
lower than before the procedure (5.5+/-2.3). There were no complications. Two
months after Discogel((R)) administration, the initial pain level had fallen by
an average of 74+/-34%. The outcome was quite stable over time (mean follow-up:
8months). At the end of the follow-up period, 60.7% of the patients were free of
pain, 76% considered the treatment outcome to be good or very good, 74% had
returned to work and 76% would recommend the treatment to a friend. CONCLUSION:
The favourable outcomes associated with the procedure should now be confirmed in
a controlled trial.
CI - Copyright (c) 2013. Published by Elsevier Masson SAS.

Langue : ANGLAIS ; FRANCAIS