Intradiscal therapy with 10% hypertonic saline for lumbar disc herniation / 介入放射学杂志

ABSTRACT

Objective A clinical trial of intradiscal injection of hypertonic saline to treat lumbar disc herniation, and observation of its effect, complications and changes in intervertebral disc tissue were performed for clinical application. Methods Discography was performed under local anesthesia, followed by a single injection of 1.0～2.5 ml 10% hypertonic saline. Results 262 cases were included in the study, with 4 years of average follow up. The final outcome ranked excellent in 93 cases and good in 100 cases. As a whole, the effective rate was 75.7% and the improvement rate was 71.5%. The procedure was effective in protrusion and confined extrusion types. 13 cases (6.7%) relapsed after the injection. No complication occurred. 26 cases resorted to surgery because of failure in intradiscal therapy, but no change was found, in the nerve and surrounding tissue of the intervertebral disc attributable to the injection during the surgical operation. The main causes of failure were the marked protrusion or non-contained extrusion, or the combination with spinal canal stenosis. Changes in the nucleus pulposus shown microscopically were similar to those resulted by the action of enzyme injection, but the injury to the disc was much milder.Conclusions Intradiscal therapy with 10% hypertonic saline for lumbar disc herniation is effective, mini-traumatic and safe.