Chemonucleolysis represents a minimally invasive percutaneous technique characterized by an intradiskal injection of materials under fluoroscopic or CT guidance. Recently, a substance based on radiopaque gelified ethanol has been introduced. The purpose of this study was to describe the indications, procedure, safety, and efficacy of radiopaque gelified ethanol in the percutaneous treatment of cervical and lumbar disk herniations. Between September 2010 and August 2013, 80 patients (32 women and 48 men; age range, 18-75 years) were treated for 107 lumbar disk herniations (L2-L3, n = 1; L3-L4, n = 15; L4-L5, n = 53; and L5-S1, n = 38) and 9 cervical disk herniations (C4-C5, n = 2; C5-C6, n = 2; C6-C7, n = 3; and C7-D1, n = 2) by percutaneous intradiskal injection of radiopaque gelified ethanol under fluoroscopic guidance. Thirty-six patients underwent a simultaneous treatment of 2 disk herniations. Patient symptoms were resistant to conservative therapy, with little or no pain relief after 4-6 weeks of physical therapy and drugs. All patients were evaluated by the Visual Analog Scale and the Oswestry Disability Index. Sixty-two of 73 (85%) patients with lumbar disk herniations and 6/7 (83%) patients with cervical disk herniations obtained significant symptom improvement, with a Visual Analog Scale reduction of at least 4 points and an Oswestry Disability Index reduction of at least 40%. Leakage of radiopaque gelified ethanol in the surrounding tissues occurred in 19 patients, however without any clinical side effects. In our experience, percutaneous intradiskal injection of radiopaque gelified ethanol is safe and effective in reducing the period of recovery from disabling symptoms.

A comprehensive description of the literature regarding interspinous process devices (IPD) mainly focused on comparison with conservative treatment and surgical decompression for the treatment of degenerative lumbar spinal stenosis. Recent meta-analysis and articles are listed in the present article in order to establish IPD pros and cons.

Purpose: Imaging guided radiofrequency ablation (RFA) of medial branches is generally followed by a long-lasting therapeutic efficacy, in patient with lumbar facet joints syndrome (LFJ). CT or fluoroscopic guidance are commonly used for RFA. The aim of the present study was to evaluate the feasibility of RFA under ultrasonography (US) guidance and the clinical outcome. Materials