Discogel Smart Health Solutions Ltd Exclusive Distributor of

Discogel® Smart Health Solutions Ltd. Exclusive Distributor of A New Solution For An Old Problem… smarthealthsolutions. ca info@smarthealthsolutions. ca sales@smarthealthsolutions. ca Discogel® Nucleoplasty

No Response? Minimally Invasive (Discogel) No Response? Conservative Remember: keeping better posture & Strengthen muscles in all 3 steps Surgery

smarthealthsolutions. ca Introduction: Chemonucleolysis is an efficient technique for the treatment of back pain; it consists of a percutaneous intradiscal injection that dissolves the nucleus pulposus and lowers intradiscal pressure.

smarthealthsolutions. ca History… Several years ago, the most widely used substance for this was chymopapain, which had an efficacy of close to 80% in lumbar disk herniations and close to 85% in cervical disk hernias but was withdrawn from the market due, in part, to anaphylactic reactions to this enzyme.

smarthealthsolutions. ca New Material… After this, the search for a new drug that could have the same efficacy as chymopapain but without the complications led to the use of pure ethanol for chemonucleolysis with very good results and no allergic complications.

smarthealthsolutions. ca New Problems… The problem with pure ethanol was the high diffusibility of the liquid, which sometimes led to radicular burning pain after the procedure and, more important, to epidural leaks, which could be severe especially at the cervical level, where the spinal cord is closer to the dura.

smarthealthsolutions. ca Problems with Pure Ethanol Properties of ethanol applied with « success » to percutaneous treatment of disco root conflicts Pure ethanol: risk of important epidural & radicular leakages

smarthealthsolutions. ca New Looks for More Security… A mixture of Gellified pure ethanol and a thickening substance with tungsten powder. Secured by: Cellulose “gel making action” limiting the risk of epidural leakage of pure ethanol Presence of tungsten particles → monitoring the progression of the gel through the annular cracks under fluoroscopy and CT

smarthealthsolutions. ca DISCOGEL® * Tungsten as non ferrous metal MRI possibility * Treatment can be ambulatory * Minimally invasive treatment (limits risks of infection) * Local Anesthesia * Absence of immediate and late complications * The lack of disk space narrowing

Discogel in Textbooks 1) I spine: Evidence-Based Interventional spine care 2) Interventional Neuroradiology of the Spine: Clinical Features, Diagnosis and … 3) Image-Guided Interventions: Expert Radiology Series 4) CT- and MR-Guided Interventions in Radiology 5) Multi-Detector Ct Imaging: Abdomen, pelvis and CAD Applications, Volume 2

smarthealthsolutions. ca Patient Selection (Best Candidates for discogel) Note: The Most Important Criteria for Better Response is Correct Patient Selection ! Single Level Symptomatic HD Leg Pain More than Back pain No Response to medical Treatments for 4_6 weeks

smarthealthsolutions. ca The Most Important Criteria for Better Response is Correct Patient Selection ! The Best Pfirmann grade: 1 -3

smarthealthsolutions. ca Relative Contraindications Coagulations disorders Un controlled Bleeding Tendency Anticoagulant Therapy Sever Deg. Disc Dis. ( more than 2/3 disc height Loss ) Primary or Metastatic Tumor Prior surgical treatments at the same level

smarthealthsolutions. ca Bad Selections Very Obese patients � Back non discogenic pain more than leg pain � Psychotic patients � Calcified Disc � Wide Herniated discs � Significant Narrowing of Disc Space � Complex Syndrome dependent upon 3 or more discal space �

smarthealthsolutions. ca Absolute Contraindications � � � � � Asymptomatic Disc Bulging as Incidental Finding In MRI Degenerative Canal & Foraminal stenosis Spondilolistesis Segmental Instability/ Fractures Local and systemic infections Pregnancy Cauda Eq. syndrome Acute Progressive Motor deficit Migrated Free Fragments Efficacy of medical treatment 

Cardiovascular and Interventional Society of Europe ( CIRSE )

smarthealthsolutions. ca

From: ajnr. org

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