sábado, 21 de abril de 2012

Etanol gelificado intradiscal


Inyección intradiscal e intramuscular de Discogel- Etanol radiopaco gelificado: evaluación patológica
Intradiscal and Intramuscular Injection of  Discogel® - Radiopaque Gelified Ethanol: Pathological Evaluation
G. GUARNIERI, G. DE DOMINICIS*, M. MUTO
Neuroradiology Service, The Cardarelli Hospital; Naples, Italy
Unit of Pathology, The Cardarelli Hospital; Naples, Italy
The Neuroradiology Journal 23: 249-252, 2010

SUMMARY - This study assessed the impact and modification of intradiscal, intraforaminal, epidural and intramuscular swine injection of a new material, Discogel®- radiopaque gelified ethanolrecently introduced for the mini-invasive treatment of herniated disc. Discogel® is a sterile viscous solution containing ethyl alcohol, cellulose derivative product, added to a radio-opaque element, tungsten. The pig was sedated and under fluoroscopy guidance a needle was positioned within disc L1-L2 followed by intradiscal, intraforaminal, epidural and intramuscular injection of 1 ml of Discogel. As disc control level L4-L5 was considered where nothing was injected. The pig was sacrifed 48 h after injection of discogel and the spine from D10 to S1 was removed and fixed in 10% buffered formalin. The anatomical specimens were cut with an electric saw and analyzed by routine technique then stained with formalin. The specimens containing bone material were treated by DEKAL solution. The specimens were stained with hematoxylin-eosin method and then analyzed by histochemical (Masson -Van Gieson PAS and trichromic stains ) and immunochemical methods. Morphostructural examination disclosed a granular material coloured black by hematoxylin-eosin method (tungsten) in paravertebral tissue both in the muscular and connective tissue. Some inflammatory elements like lymphomonocyte cells and venous stasis were found. No alteration was found where discogel was injected, and the nucleus pulposus, disc, chondromixoid and root ganglium were normal. After intradiscal, intraforaminal, epidural and intramuscular injection of Discogel® no morpho-structural changes in nuclear tissue and annulus were found. Further studies on pigs with immunohistochemical analysis after treatment will confirm the morphological alterations induced by discogel and its action. Key words: Discogel, herniated disc
http://www.ortomedica.ro/images/pdf/3.pdf  

Tratamiento percutáneo de las hernias de disco cervicales con etanol gelificado
Percutaneous treatment of cervical disk hernias using gelified ethanol.
Theron J, Cuellar H, Sola T, Guimaraens L, Casasco A, Courtheoux P.
Department of Neuroradiologie, CHU Côte de Nacre, Caen, France.theronjcq@aol.com
AJNR Am J Neuroradiol. 2010 Sep;31(8):1454-6. Epub 2010 Jan 6.
Abstract
This study investigates the efficacy of chemonucleolysis using RGE in the treatment of cervical disk hernias in a small sample of patients who had cervical diskogenic or radicular pain secondary to disk herniations. Results were satisfactory in 89.5% patients, with no adverse events recorded during the procedure or after. The use of RGE shows promising results and might be a feasible and safe alternative in the treatment of cervical disk hernias

http://www.ajnr.org/content/31/8/1454.full.pdf+html

 
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Anestesiología y Medicina del Dolor

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