Effectiveness of intradiscal injection of radiopaque gelified ethanol (DiscoGel(®)) versus percutaneous laser disc decompression in patients with chronic radicular low back pain

BACKGROUND: Low back pain secondary to discopathy is a common pain disorder. Multiple minimally invasive therapeutic modalities have been proposed; however, to date no study has compared percutaneous laser disc decompression (PLDD) with intradiscal injection of radiopaque gelified ethanol (DiscoGel(®)). We are introducing the first study on patient-reported outcomes of DiscoGel(®) vs. PLDD for radiculopathy. METHODS: Seventy-two patients were randomly selected from either a previous strategy of PLDD or DiscoGel(®), which had been performed in our center during 2016–2017. Participants were asked about their numeric rating scale (NRS) scores, Oswestry disability index (ODI) scores, and progression to secondary treatment. RESULTS: The mean NRS scores in the total cohort before intervention was 8.0, and was reduced to 4.3 in the DiscoGel(®) group and 4.2 in the PLDD group after 12 months, which was statistically significant. The mean ODI score before intervention was 81.25% which was reduced to 41.14% in the DiscoGel(®) group and 52.86% in the PLDD group after 12 months, which was statistically significant. Between-group comparison of NRS scores after two follow-ups were not statistically different (P = 0.62) but the ODI score in DiscoGel(®) was statistically lower (P = 0.001). Six cases (16.67%) from each group reported undergoing surgery after the follow-up period which was not statistically different. CONCLUSIONS: Both techniques were equivalent in pain reduction but DiscoGel(®) had a greater effect on decreasing disability after 12 months, although the rate of progression to secondary treatments and/or surgery was almost equal in the two groups.