Original Title: Análisis de la eficacia, seguridad y eficiencia de la estabilización de los discos intervertebrales mediante Discogel

Authors' objectives: Assess the scientific evidence on the efficacy, safety and efficiency of the percutaneous treatment of intervertebral disc herniations using radiopaque gelified ethanol (Discogel®).

Authors' results and conclusions: The search result gave nine articles for analysis of the efficacy and safety of the Discogel® system. No article that assessed the efficiency of the treatment was found. The total success rate of the procedure, defined in most studies as the absence or substantial reduction of pain and not limitation or minimum limitations on carrying out physical activities, obtained independently of the type of study and patient, is 81.4 % (487/598 patients). However, if each study is independently analysed, the success rate varies between 91.4 % and 36 %. It appears from the articles assessed that Discogel® is a safe procedure, in which no major complications relating to the treatment can be observed (allergic reactions, morbid events, etc.) during the intervention itself or after treatment and during the monitoring phase. The economic analysis shows that the cost per patient and year of treatment with Discogel® is 4,468.10 €. CONCLUSIONS The evidence from the revision, of poor scientific quality, with a low volume of patients and with scarce monitoring of them over time, suggests that Discogel® is a treatment that appears to be safe, simple and quick to use and that for a sizeable proportion of patients can eliminate or reduce the pain and physical limitations caused by irritation of the nerve root as a result of a disc herniation. New prospective, controlled and randomised trials are required to confirm these results.

Authors' methods: To analyse the efficacy, safety and efficiency of the Discogel® system, a systematic revision was carried out of the scientific evidence using a structured search in data bases that specialise in systematic revisions, general data bases of medical literature and specific data bases of economic studies. A critical review of the localised literature was also carried out, along with a synthesis and an assessment of the results with regard to the National Health System. An economic assessment was also conducted to establish the cost per patient and year of treatment with Discogel®.

Project Status: Completed

Year Published: 2017

URL for published report: https://www.ogasun.ejgv.euskadi.eus/r51-catpub/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=051990&N_EDIC=0001&C_IDIOM=mu&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government