Article Figures & Data
Figures
- Fig 1.
Progressive intervertebral disk filling of RGE. Real-time fluoroscopic images showing RGE inside the nucleus pulposus and in the herniated disk (arrows). Tungsten allows proper visualization of the material, including monitoring of possible leakage.
- Fig 2.
VAS scores recorded before and after percutaneous intradiskal injection of RGE. The left panel displays the boxplot of the data. Before treatment, the VAS scores were mostly concentrated on the upper values of the scale (median = 7; 25th percentile = 7; 75th percentile = 8); therefore, this distribution was negatively skewed (skewness = −0.29). The distribution of the VAS scores in the posttreatment survey (median = 3; 25th percentile = 2; 75th percentile = 4) became positively skewed (skewness = 0.91). No outliers were identified. The reduction of 4 points in the median of the VAS scores between pre- and posttreatment was significant for the nonparametric Wilcoxon matched-pairs signed rank test (W = −3076; P < .0001). The barplots in the right panel show the means and SDs of the data. The decrease of the means of the VAS scores from 7.16 ± 0.79 to 3.61 ± 1.72 was significant under the paired t test with 78 df (t = 17.61; P < .0001).
- Fig 3.
ODI scores recorded before and after percutaneous intradiskal injection of RGE. The index is expressed in percentage points and ranges from 0% to 100%. The lower limit corresponds to the absence of disability; the upper limit, to the maximum degree of disability (patients are bed-bound). The left panel displays the boxplot of the data. Before treatment, the distribution of ODI scores (median = 48%; 25th percentile = 42%; 75th percentile = 58%) was slightly negatively skewed (skewness = −0.05), and it became positively skewed (skewness = 1.21) in the posttreatment survey (median = 14%; 25th percentile = 10%; 75th percentile = 18%). No outliers were identified. Between the pre- and posttreatment periods, the medians of the VAS scores dropped by 34 percentage points. This decline was significant for the nonparametric Wilcoxon matched-pairs signed rank test (W = −3076; P < .0001). The barplots in the right panel show the means and SDs of the data. The decrease of the mean of the ODI scores from 47.85 ± 9.05 to 17.47 ± 14.41 was significant with the paired t test with 78 df (t = 17.71, P < .0001).
- Fig 4.
Treatment of a very large extruded LDH in a 58-year-old woman with left sciatica (VAS = 8). A, In a preoperative MR imaging study, sagittal and axial T2 sequences show a large uncontained and partially migrated disk herniation at L5–S1 (median left posterolateral), with considerable root involvement (white arrow). B, CT control shows the optimal distribution of RGE in a disk herniation without leakage (black arrow). The patient did not have significant symptoms (VAS = 3). C, MR imaging study obtained 6 months later shows complete dehydration and retraction of disk herniation. The patient was completely asymptomatic (VAS = 0).
- Fig 5.
Treatment of a CDH in a 45-year-old woman with left brachialgia (VAS = 7). A, T2-weighted sagittal and T2*-weighted axial MR images show a C4–C5 left posterolateral disk herniation. Note also other asymptomatic disk bulging at the C3–C4, C5–C6, and C6–C7 levels. Anteroposterior radiograph (B) and CT axial image (C) obtained at the end of the procedure confirm the proper distribution of RGE in the treated disk, especially in the herniated portion (arrows).
