The Oving Clinic
tel: 01243 773167
Open: 9AM-6PM
Tuesday: 9AM-9PM

INTRADISCAL THERAPIES

Dr J Tanner is an instructor for SIS – Spine Intervention Society – and sits on the European Faculty Board.

INTRADISCAL THERAPIES

If discography provokes your typical pain in the back and/or leg there are several options in treatment. The first is injection of water soluble corticosteroid into the disc space. This can give lasting relief in the occasional patient but up to 1 in 3 experience reasonable short term relief.

Currently there is no entirely satisfactory solution for discogenic pain. Milder cases may respond to prolotherapy. Severe disabling pain may be better treated by surgical fusion or disc replacement. Moderately disabled patients may prefer to try IDET although there is only a 1 in 5 chance of an adequate response.

Nucleoplasty is an option but the degree of disc degeneration cannot be too severe (ie more than 50% narrowing) or there will be no benefit. We are still waiting for good evidence on the application of coblation nucleoplasty for purely discogenic pain, when there is no contained protrusion.

There are new technologies to treat painful internal disc disruption being developed all the time. It takes time and good scientific control to try and test these all methods.

One of the more promising ones being used in Europe is called Bi-Acuplasty or ‘cold RF’. Up to this date the evidence remains anecdotal. Once there is proof of its effectiveness it will be available here at the Oving Clinic.

To summarise suggested plan for positive Discogram:

  1. Try intradiscal steroid
  2. Prolotherapy to stabilise motion segment
  3. Consider other ‘new’ intradiscal minimally invasive therapies OR discuss surgical options:
    • dynamic posterior stabilisation (Dynesus, Wallis Ligament)
    • Fusion
    • Disc replacement (PRODISC)

If you have further questions please contact us.

Share this page