Academic literature on the topic 'Injections, Intradiscal Complications'
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Journal articles on the topic "Injections, Intradiscal Complications"
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Theron, J., H. Huet, and O. Coskun. "Cervical Automated Discectomy." Interventional Neuroradiology 2, no. 1 (March 1996): 35–44. http://dx.doi.org/10.1177/159101999600200104.
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The lumbar automated discectomy system described by Onik has been used in the treatment of cervical disk herniations whose symptomatology resisted medical treatment. Experience on 150 patients is reported showing a 74.5% success rate. This series performed in most cases on an outpatient basis had no complications. Up to 1992 failure cases were treated by intradiscal injections of triamcinolone with 62% of success. This complementary technique was abandonned after the description of epidural calcifications secondary to this type of injections in the lumbar area. Since 1992, failure cases have been managed differently with injections of steroids in the cervical joints, especially when a hypertrophy of the ligamentum flavum supposedly a sign of an inflammatory posterior component of the pain was demonstrated on the CT. Nine patients received intradiscal injections of microdoses (600 IU) of chymopapaine with excellent results. No patient has had open surgery since 1992. It is concluded that percutaneous automated discectomy is a very promising and safe technique which can be used as a first choice technique for most cervical disk herniations resisting medical treatment.
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Veihelmann, Andreas. "Spinal Injections, Epidural Neurolysis and Denervation for Specific Low Back Pain and Sciatica." Zeitschrift für Orthopädie und Unfallchirurgie 157, no. 04 (November 27, 2018): 417–25. http://dx.doi.org/10.1055/a-0767-7428.
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Abstract Background Many members of the adult population suffer acute low back pain at some stage in life. A specific cause is found in only a rather small number of these patients. Some of the patients develop chronic low back pain and this is a major source of disability. On the other hand, there has been a great increase in Germany in the number of spinal operations due to degenerative spine disease and, in turn, unnecessary surgery on the spine is under debate. Methods This is a narrative review of different minimally invasive spine procedures in the treatment of specific low back pain. The effectiveness of spinal injections, radiofrequency of the facet joints as well as epidural adhesiolysis/neurolysis are described. An analysis of the literature was performed via PubMed, Medline and the Cochrane Database. Results Facet-, epidural and intradiscal steroid injections for specific pain generators in the degenerative spine show different short- and long-term results; they are able to improve low back pain in specific patients with chronic low back pain and may be able to prevent some of these patients from having to undergo open surgery. Furthermore, there are promising results from interventions such as epidural neurolysis for sciatica and radiofrequency of the medial branch of the dorsal root for the treatment of axial facet-related back pain. Facet and intradiscal steroid injections give only short-term effects in axial low back pain and should therefore only be considered reluctantly, whereas the different forms of epidural steroid injections in patients with sciatica due to radicular compression offer a well proven adjuvant treatment option within a conservative therapeutic regimen. The overview of the literature with the use of different steroids has shown that use of non-particulate steroids show better results with respect to the safety and avoidance of major complications, especially when used at the cervical spine. However, in Germany the use of these steroids is still off label and patients have to give informed consent prior to injection. In summary, careful use of spinal injections and interventions within a conservative physiotherapeutic regimen seem to improve chronic back pain and, in turn, to be able to prevent some patients from having to undergo spine surgery.
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He, Xf, YY Xiao, YH Li, W. Lu, Y. Chen, HW Chen, J. Pen, et al. "Percutaneous Intradiscal O2-O3 Injection to Treat Cervical Disc Herniation." Rivista di Neuroradiologia 18, no. 2_suppl (October 2005): 75–78. http://dx.doi.org/10.1177/19714009050180s215.
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We evaluated the safety and therapeutic effect of treating cervical disc herniation with O2-O3 mixture injection into the intradiscal space. 58 patients with 126 herniated discs verified by MRI were selected for the study, and all patients presented the symptoms of upper limb, cervical and shoulder pain. The procedures were guided by fluoroscopy (28 cases) and by CT (30 cases). The puncture route was defined between the right common carotid artery and trachea clearance. 1∼2 ml O2-O3 mixture at 30–40 ug/mL was injected into each herniated disc space. 58 patients were followed up from three to 30 months after treatment. The therapeutic effect showed that 33 cases (56.9%) had excellent recovery, 11 cases (19.0%) had significant relief of symptoms, and 14 cases (24.1%) resulted in treatment failure. No serious complication occurred. The therapeutic method developed by using O2-O3 mixture injection in cervical intradiscal space was a safe and effective method for the treatment of cervical disc herniation.
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Giurazza, Francesco, Gianluigi Guarnieri, Kieran J. Murphy, and Mario Muto. "Intradiscal O2O3: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation." Canadian Association of Radiologists Journal 68, no. 2 (May 2017): 171–77. http://dx.doi.org/10.1016/j.carj.2016.12.007.
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The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (O2O3) at very low concentrations for 15 years in Europe. The main indication is back pain with or without radicular pain but without motor deficits, which is refractory to 4-6 weeks of conservative therapies. Its mechanism of action on the disc is mechanical (volume reduction by subtle dehydration of the nucleus pulposis) and antinflammatory. The intradiscal ozone injection is performed with a thin needle (18-22 gauge) image guided by computed tomography or angiofluoroscopy and is usually complimented by periganglionic injection of corticosteroids and anesthetics. This combination gives immediate pain relief and allows time for the ozone to act. It is a cost-effective procedure that presents a very low complication rate (0.1%). The radicular pain is resolved before the back pain does, as is seen with microdiscectomy. Peer-reviewed publications of large randomized trials, case series, and meta analysis from large samples of patients have demonstrated the procedure to be safe and effective in the short and the long terms, with benefits recognized up to 10 years after treatment. We aim to review the principles of action of O2O3 and report the injection techniques, complications, and short- and long-term outcomes.
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Amoretti, Nicolas, Jean Baqué, Stéphane Litrico, Nicolas Stacoffe, and William Palmer. "Serious Neurological Complication Resulting from Inadvertent Intradiscal Injection During Fluoroscopically Guided Interlaminar Epidural Steroid Injection." CardioVascular and Interventional Radiology 42, no. 5 (January 2, 2019): 775–78. http://dx.doi.org/10.1007/s00270-018-2151-5.
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Muto, M., and F. Avella. "Percutaneous Treatment of Herniated Lumbar Disc by Intradiscal Oxygen-Ozone Injection." Interventional Neuroradiology 4, no. 4 (December 1998): 279–86. http://dx.doi.org/10.1177/159101999800400403.
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We report our experience of treating lumbar herniated disc by intradiscal injection of an oxygen-ozone mixture. Ozone (03, MW = 48) is a triatomic molecule, having antiviral, disinfectant and antiseptic properties. Several mechanisms of action have been proposed to explain the efficacy of the treatment: analgesic action; anti-inflammatory action; oxidant action on the proteoglycan in the nucleus pulposus. We treated 93 patients (50 women, 43 men) aged from 24 to 45 yrs (average age 38 yrs) from June 1996 to April 1998. All patients presented sciatica and/or low back pain, lasting two or more months; patients had in the mean time received both medical and physical therapy with mild or no benefit. Diagnostic tests in all patients included plain film x-ray, CT and/or MR at the level of the lumbar spine disclasing a herniated or protruded disc with nerve root or thecal sac compression. We divided patients to be treated in to two groups: the first one group included 35 patients already selected for surgery who presented herniated or protruded disc with radicular pain with associated neurological deficit (hypoesthesia and partial loss of reflex). Those patients had already had medical and physical therapy for two or more months and agreed to try the percutaneous treatment before surgery. CT or MR in this group demonstrated the presence of intraforaminal, extra or sub-ligamentary and sequestrated herniated disc. The second group included 58 patients with radicular pain but without neurological deficit; patients in this group had received medical and/or physical therapy for two or more months and CT showed the presence of a small subligamentary herniated or protruded disc. We considered the results according to the modified MacNab method. In the first group we had “failure” in all patients; in seven cases the symptoms improved for one month, but recurred later on. In the second group 45 patients had “success” showing complete clinical recovery within five to six days after treatment, all remained without symptoms up to six months or more of follow-up. The remaining 13 patients presented the same symptoms again within three months after a temporary clinical recovery. The goal of this study was to present this new technique that can also be compared with a previous study of different percutaneous treatment. Clinical and neuroradiological indications and the contraindications are well known, and must be followed to achieve good results and avoid complications.
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Beyaz, Serbülent Gökhan. "Six-Month Results of Cervical Intradiscal Oxygen-Ozone Mixture Therapy on Patients with Neck Pain: Preliminary Findings." January 2018 1, no. 21;1 (July 15, 2018): E499—E456. http://dx.doi.org/10.36076/ppj.2018.4.e449.
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Background: Numerous techniques have been developed for the treatment of disc herniation. Oxygen-ozone (O2 -O3 ) mixture therapy is a minimally invasive percutaneous treatment for disc herniation. Objective: The aim of the study is to investigate the 6-month efficacy and safety of O2 -O3 mixture therapy in patients with cervical disc herniation (CDH) and chronic neck pain. Study Design: This is a cross-sectional, single-center study. Setting: The study was conducted from January 2012 to May 2016 on patients visiting Sakarya University Training and Research Hospital’s pain clinic. Methods: Each patient was evaluated before the procedure (baseline) and at 2 weeks (W2), 6 weeks (W6), and 6 months (M6) after the procedure using the visual analog scale (VAS) and the Oswestry Disability Index scores. Results: A total of 44 patients with CDH underwent the same treatment with an O2 -O3 mixture. Significant pain relief was observed compared with preoperative pain at W2, W6, and M6 according to patient self-evaluation (P = 0.01). The mean VAS score was 7.89 ± 1.13 before the procedure, 4.22 ± 1.62 at W2, 3.03 ± 1.66 at W6, and 2.27 ± 1.25 at the end of M6. No significant complications or side effects were reported during or after the procedure. Limitations: Our study was conducted retrospectively, which resulted in problems obtaining follow-up data. In addition, this study was performed in a small patient group. Conclusion: Based on our results, intradiscal injection of an O2 -O3 mixture treatment showed a beneficial long-term effect. Key words: Cervical disc herniation, chemonucleolysis, injection, intradiscal, oxygen-ozone mixture, percutaneous treatment
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Zeiger, Evan H., and Edward J. Zampella. "Intervertebral Disc Infection after Lumbar Chemonucleolysis: Report of a Case." Neurosurgery 18, no. 5 (May 1, 1986): 616–21. http://dx.doi.org/10.1227/00006123-198605000-00017.
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Abstract Intervertebral disc space infection can be a serious and disabling complication of any procedure that affords entry for bacteria into the susceptible disc space. Most disc space infections occur after cervical or lumbar laminectomies. Discitis has been reported after myelography, lumbar puncture, paravertebral injection, and obstetrical epidural anesthesia. A case of septic discitis occurring after intradiscal therapy with chymopapain is presented. Patients who return for evaluation of recurrent spinal pain after chemonucleolysis, especially those with paravertebral muscle spasm, should be evaluated for the possibility of disc space infection by obtaining an erythrocyte sedimentation rate, peripheral white count, differential cell count, and plain roentgenograms. Radionuclide bone scans, although not specific, may provide further objective evidence leading to the diagnosis of an intervertebral disc space infection.
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Bosnjakovic, P., S. Ristic, M. Mrvic, A. E. Miljkovic, T. Vukicevic, G. Marjanovic, and L. Macukanovic-Golubovic. "Management of painful spinal lesions caused by multiple myeloma using percutaneous acrylic cement injection." Acta chirurgica Iugoslavica 56, no. 4 (2009): 153–58. http://dx.doi.org/10.2298/aci0904153b.
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Background and purpose: Spinal lesions with marked destruction are common site of morbidity in patients with multiple myeloma causing serious clinical symptoms. The aim of the study was to evaluate the therapeutic benefit of percutaneous vertebroplasty (PVP) in treating vertebral body lesions in patients suffering from multiple myeloma. Materials and methods: Twenty nine patients (55 vertebral bodies) were treated after complete diagnostic evaluation, preparation and obtaining informed consent. Needle position and acrylic material injection was performed under fluoroscopic guidance. Results: Average visual analogue score dropped from 7.8 before to 2.3 after the intervention. Soft tissue leak was present at 9 treated levels, small epidural cement collection at 5, venous leak at 4 and intradiscal leak at 3 levels without any clinically manifest complications. The effects of PVP were stable in all of the patients at 12 months follow-up. Subjective outcome scores collected through follow-up showed improvement of +1.45 in pain, + 1.15 in ambulation and + 1.23 in medication use. There were recurrence of back pain in 9 patients at non-treated levels due to the new lesions. Conclusion: In our series, PVP of painful lesions caused by multiple myeloma provides immediate and long-term pain relief. The procedure is safe and, despite of the present leakage of cement, may be performed on outpatients basis.
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Ezeldin, Mohamed, Marco Leonardi, Ciro Princiotta, Massimo Dall’olio, Mohammed Tharwat, Mohammed Zaki, Mohamed E. Abdel-Wanis, and Luigi Cirillo. "Percutaneous ozone nucleolysis for lumbar disc herniation." Neuroradiology 60, no. 11 (September 11, 2018): 1231–41. http://dx.doi.org/10.1007/s00234-018-2083-4.
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Abstract Purpose All percutaneous minimally invasive disc treatments are typically indicated to contained disc herniations. Our study’s aim is to evaluate prospectively the efficacy of ozone nucleolysis in the treatment of either contained or uncontained lumbar disc herniations. Methods Fifty-two patients, aged 27–87 years, with symptomatic herniated lumbar discs, without migration, sequestration, or severe degenerative disc changes, who failed conservative treatment, were included in our study. The patients underwent fluoroscopic-guided intradiscal oxygen-ozone mixture injection (5 ml) at a concentration of 27–30 μg/ml and periradicular injection of the same O2-O3 mixture (10 ml), steroid (1 ml), and local anesthetic (1 ml). Clinical outcomes were evaluated, based on the Oswestry Disability Index (ODI) and pain intensity (0–5) scale results, obtained initially and at 2- and 6-month controls. Our results were analyzed by ANOVA and chi-squared (χ 2) tests. Results Our initial results obtained at 2-month control were promising, indicating a significant decrease in pain disability and intensity in 74% (37) and 76% (38) of the patients respectively, and minimally increased to 76% (38) and 78% (39) at 6-month control (P < 0.001 and CI 99.9%). The mean preprocedure ODI and pain intensity scores were 35 ± 14.36 and 2.38 ± 0.90, respectively, which were reduced to 19.36 ± 13.12 and 1.04 ± 0.92 at 6-month control. Our failure had been mostly related to long symptoms duration of more than 1 year. No complications were recorded. Conclusion Ozone nucleolysis is a safe cost-effective minimally invasive technique for treatment of contained and uncontained lumbar disc herniations.
Dissertations / Theses on the topic "Injections, Intradiscal Complications"
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Fraser, Robert D. "Discitis after discography and chemonucleolysis /." Title page, table of contents and abstract only, 1986. http://web4.library.adelaide.edu.au/theses/09MD/09mdf842.pdf.
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Fraser, Robert D. (Robert David). "Discitis after discography and chemonucleolysis." 1986. http://web4.library.adelaide.edu.au/theses/09MD/09mdf842.pdf.
Full textBooks on the topic "Injections, Intradiscal Complications"
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Patel, Vikram B. Basics of Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0001.
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This chapter reviews the basics of fluoroscopy, including its safe use and the dangers of radiation. Although various interventions have been used to treat pain for decades, use of fluoroscopy has been more prevalent since the mid-1990s. Several studies have shown that using any form of guidance is superior to “blind” procedures, providing better outcomes while reducing the rate of complications. Ultrasound may be safer than fluoroscopy for certain procedures such as joint injections near and around blood vessels. Ultrasound avoids the harmful radiation to the patient, the treating physician, and staff, and also helps significantly by allowing the physician to visualize blood and fluid flow. Nevertheless, fluoroscopy may never be replaced for certain procedures that require full view of osseous structures or for open but minimally invasive surgical procedures such as implantable devices and intradiscal procedures.