Disc herniations (Disc bulge) are a common cause of back pain and discomfort in the gluteal area and legs. They affect all age groups.

These symptoms are caused by protrusions of intervertebral discs which exert pressure on the spinal nerves. If the symptoms do not resolve spontaneously or under conservative treatment (e.g. physiotherapy) a neurosurgical procedure in the spinal canal is often necessary to remove the disc prolapse. If scar tissue forms after the surgery it can cause symptoms similar to the removed disc prolapse: This is referred to as “failed back syndrome”.

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Intradiscal Microtherapy with DiscoGel®

Without the necessity of a surgical procedure disc herniations can be treated with a minimally-invasive procedure using DiscoGel®. DiscoGel® modifies the core of the intervertebral disc in such a way that the disc herniation resolves. The treatment is carried out under local anaesthesia. DiscoGel® is introduced through a fine needle into the intervertebral disc without the need to open up the spinal canal. The micro-therapy is carried out under the precise guidance afforded by computed tomography. There is no scar formation. The procedure takes between 20 and 30 minutes. Afterwards, the patient can go home. A hospital stay and postoperative physiotherapy are not necessary.

Good to very good results are achieved in over 90 % in patients with simple, acute disc herniations, in more complicated cases in 80 to 85 %.

Intra-Discal Microtherapy with DiscoGel® affords rapid pain relief

Back pain is one of the most common medical complaints in the western world. Up to 80 % of the population is affected. If the initial complaints do not spontaneously subside within a few days, magnetic resonance imaging (MRI) is employed for diagnostic work-up.

Special MRI Scan Necessary to Identify Source of Pain Reliably

Not every MRI scan, however, is suitable to reveal the reason for the patient’s complaints. The reason for this is that the pain is caused by an inflammation, which must be identified. This, however, is only possible through the application of an MRI contrast agent and specific imaging methods which can reveal the inflammation and differentiate it reliably from other findings. In some cases and additional MRI scan under weight bearing conditions (simulated up-right MRI) is necessary.

Disc Herniation (Disc bulge) as a Cause of Back-Pain and Nerve Irritation

Disc herniations are common. Only in 5 % of all cases, however, is a disc prolapse the cause for the patient’s complaints. Of those cases, only a small number has to undergo surgical treatment (cauda equine-syndrome, rapidly progressive paralysis). The majority can be treated conservatively (with physiotherapy etc.) or with minimally-invasive micro-therapy.

Therapy of Disc Herniation (Disc bulge) with DiscoGel®

The latest development in this area is the intra-discal micro-therapy with DiscoGel®. This treatment method, which as developed by French researchers, utilises a congealed alcohol mixed with a contrast agent, which is injected through a thin canula directly into the intervertebral disc. The compound results in a loss of the water storage capacity of the intervertebral disc by denaturation the proteo-glycan matrix of the nucleus pulposus. This in turn results in a progressing decompression of the effected spinal nerves within hours to a few days.

The interventional procedure can be carried out on an out-patient basis in local anaesthesia and without pain. The success rates are high: 80 – 90 % of all patients are without symptoms and free of complaints within three months after treatment.

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A: Disc herniation with nerve root compression. B: DiscoGel® injection into the nucleus pulposus of the prolapsed disc. C: Beginning contraction of nucleus pulposus and disc herniation with partial relief of nerve root and pain relief. D: Complete retraction of disc prolaps with complete relief of nerve root.

Advantages of DiscoGel® in Comparison with other Treatment Methods

  • Minimally invasive method with low risk
  • No surgical access to the spinal canal necessary
  • No scarring, no „failed back syndrome“, no impediment to future therapies (including surgery)
  • Out-patient procedure, hospital stay not necessary
  • No need for lengthy post-surgical physiotherapy
  • High success rate (80 – 90 %)

Micro-Therapy at the A1 Medical Center

At the A1 Medical Centerwe treat back-pain with a variety of micro-therapy methods. All interventions are carried out under sterile conditions, precisely guided by computer tomography and/or fluoroscopy.

Diagnostic and Micro-Therapeutic procedure for Disc Herniation

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To assure optimal treatment results, diagnostic work-up, indication for treatment and actual therapy are carried out in an interdisciplinary fashion by a team of Radiologist, Orthopaedic Surgeons, Neurologists and Anaesthesists:

  • Medical history-taking and re-view of medical records from other institutions (patients should bring all already existing medical records with them)
  • Special MRI-diagnostics, in necessary under axial load
  • Neurological diagnostic work-up, if necessary
  • Diagnostic micro-therapy with local anaesthesia of the irritated nerve root for precise identification of the source of the complaints
  • Treatment with DiscoGel®, if necessary in combination with peri-radicular therapy
  • Follow-up MRI 10 days after the procedure and in 3 and 6 months

The treatment with DiscoGel® takes between 20 to 40 minutes and is carried out under local anaesthesia. Additional general relaxation of the patient during the treatment is effected by medication that causes mild sedation and analgesia (pain relief). After treatment a two hour period under medical observation in one of our private patient lounges is recommended. A longer stay as an in-patient is not necessary.

Clinical Case:

Disc_Herniation_CaseAcute re-prolapse (arrows) after back surgery for disc herniation: Sagittal (left) and axial (right) T2w-MRI-images of a female patient with severe back-pain and radicular symptoms two years after surgical treatment of a disc prolapse. The relatively bright signal of the herniated disc indicates a relatively recent re-prolapse.After_Discogel_Disc_HerniationThree months after Discogel treatment: Sagittal (left) and axial (right) T2w-MRI-images of the same patient: The disc herniation has disappeared completely. The patient was free of symptoms since the time of the treatment.

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