Discogel Frequently Asked Questions

Q: What is the new treatment for spinal disc herniation?

A: Currently, Discogel is one of the latest approved treatments for individuals with disc herniation.

Q: What is Discogel?

A: "Discogel" is the trade name for a substance called "Radiopaque Gelified Ethanol or RGE," which has officially entered the world of medicine since 2007 as the most effective interventional treatment for disc herniation. This product is currently approved as an effective and low-risk treatment in many European and other countries.

Q: Is Discogel a medication?

A: No, Discogel is not a medication; rather, it is a liquid implant that transforms into a cotton-like consistency upon contact with water (inside the intervertebral disc).

Q: Is Discogel the same as Hyaluronic Acid?

A: No, Discogel and Hyaluronic Acid are completely different biochemically and have no common points with each other.

Q: Why is Discogel produced in ampoule form?

A: Discogel is prepared in injectable vial form for easier storage, transportation, and more convenient use during the injection process.

Q: What is the main indication for Discogel?

A: Discogel is used for the non-surgical treatment of herniated or ruptured intervertebral discs in various regions of the spinal column, such as the neck or lower back.

Q: What are the herniated and ruptured disc treatment steps?

A: The treatment of disc damage consists of three main stages, which are as follows: 1. Conservative treatments such as bed rest for 1 to 2 days, prescription of pain medications, physiotherapy, acupuncture, hydrotherapy, and more. 2. Interventional treatments and various injections around or inside the spinal column and discs (such as intra-discal Discogel injection). 3. Surgical treatments are chosen in case of failure of previous methods or emergencies.

Q: What are the "interventional spinal treatments"?

A: Interventional treatments are non-surgical methods typically performed under local anesthesia, aiming to address a patient's issue with minimal injury to natural body tissues. Entry into the body in interventional treatments is usually done through a needle. Therapeutic or pain-relieving actions are precisely carried out at the site of injury. Discogel injection is one of the interventional treatments for intervertebral disc herniation/rupture. Unlike some other methods, Discogel is not a pain killer, instead, it can decompress nerve roots by decreasing pressure inside the damaged disc and also by creating a defensive barrier around the injured disc area and preventing contact between pain-inducing substances and nerve roots and blood vessels.

Q: Is Discogel effective?

A: Since 2014, many other investigations have shown that intradiscal DiscoGel® injection is a minimally invasive, low-cost, safe, and effective intervention that may be a valuable choice in properly selected disc herniation cases before making plans for surgery. In a prospective study conducted on one hundred of our patients with herniated/ruptured intervertebral discs, the success rate of Discogel for lumbar discs was 87.6% and for cervical discs, it was 92%. published statistics from other research also indicate that other studies have had similar results.

Q: What is the main indication for the use of Discogel?

A: Treatment of herniated discs at any level of the spinal column.

Q: Which country manufactures Discogel?

A: Discogel is manufactured by a French company called GELSCOM.

Q: What are the ingredients in Discogel?

A: The primary components of Discogel include ethanol, ethyl cellulose, and tungsten.Ethanol is the main active substance in Discogel, and ethyl cellulose is added to gelify it.

Q: What is the reason for the presence of tungsten in the Discogel?

A: The tungsten is a radio-opaque element (opaque to X-rays) used to show “in live” the gel under fluoroscopy to control the injection of jellified alcohol. Ulterior radiological studies allow determining the site of the intervertebral disc injected and treated by Discogel.

Q: What are the advantages of Discogel treatment?

A: Discogel therapy has several advantages. It is permissible in all areas of the spinal column, including the cervical region, despite the proximity to the spinal cord and major arteries, and it can be easily performed. Discogel injections do not cause severe pain during the procedure, and any discomfort that may arise usually diminishes quickly. They do not result in damage to adjacent tissues. Furthermore, Discogel injections do not create fibrous tissue or adhesions, and if a patient needs surgery in that area for any reason, it will not complicate the procedure. This treatment can also be used to address multiple discs in the same region simultaneously. It does not reduce disc height or lead to related complications. Since Discogel is performed with a fine needle, it has no scar tissue on the skin's appearance.

Q: Does the transport and storage of Discogel require special conditions?

A: The suitable temperature for transporting and storing Discogel is between 2°C - 25 °C / store in a dark place away from light.

Q: Is Discogel only effective for treating mild disc herniations?

A: Naturally, the less severe the disc injury, the more effective Discogel tends to be. However, many individuals with severe intervertebral disc herniations, and even cases of ruptured cervical and lumbar discs, have been successfully treated with this substance.

Q: Does Discogel injection require anesthesia?

A: For Discogel injection, only local anesthesia is used at the needle insertion site. However, if necessary and based on the treating physician's recommendation, mild sedatives can be used to reduce patient stress. The type of sedation used is determined based on consultation with the treating physician and anesthesiologist. General anesthesia is not recommended for Discogel injection.

Q: How long must I stay in the hospital after Discogel therapy?

A: Most often, it is about an ambulatory intervention: once arrives at the hospital; a light intervention is performed and on the same day, it is possible to go back home.

Q: How many discs can be treated with one vial of Discogel?

A: Typically, one vial of Discogel is suitable for a maximum of four cervical discs or two lumbar discs. However, in some cases, and depending on the patient's disc size, it may be necessary to use a larger volume than the standard Discogel for each disc. In such cases, the contents of one vial may not be sufficient for two lumbar discs.

Q: Is Discogel similar to steroids or other pain relievers?

A: No, there are different mechanisms for the effectiveness of Discogel, it is not a pain killer or anti-inflammatory substance. Steroids and various medicines are usually injected to reduce local inflammation and alleviate the patient's pain and usually require repeated injections. In contrast, Discogel aims to address the underlying cause and reduce intra-discal pressure and nerve root decompression to alleviate the patient's problem. Normally, there is no need for repeated injections of Discogel.

Q: Have professional athletes used Discogel?

A: Due to patient privacy concerns, we can't provide extensive details, but one of the treated patients by Professor Jacques Theron was an Olympic gymnast. In our Discogel clinic, some professional bodybuilders, professional volleyball players, and professional soccer players in top-tier teams with diagnosed hernias and severe disc injuries have received treatment with Discogel. Almost all of these patients gradually resumed their professional sports after completing the recovery and physiotherapy period.

Q: How does Discogel work?

A: principally linked to the hydrophilic properties of the agent which make the gel soluble and generate the migration of the water from the periphery of the disc (including hernia) towards the center. The not soluble gel in the presence of water, precipitates and settles in the micro infractions of the disc to create a «flexible soft prosthesis». Note: At the time of injection, the radio-opaque gel will find its way into the fissures of the disc to reach the hernia (even if it is far from the point of injection of the disc) In the presence of water, the gel fills up hernia and fissures "highlighted" by radio-opaque compound included in the gel. The drainage of hernia contributes to the pressure of this one and decreases the stimulation of surrounding nerves (slipped disc decompression) then speeds up its necrosis and its disappearance. The disc becomes "waterproof" and the possible pro-inflammatory molecules remain sequestrated in the disc (and participate in breaking the inflammatory process: therefore diminishing pain).

Q: Is Discogel used in European countries?

A: Yes, Discogel is utilized in many European and non-European countries as a highly effective treatment for intervertebral disc herniation.

Q: Do I need to rest after a Discogel injection?

A: Discogel injection into cervical discs typically doesn't require rest unless your doctor advises otherwise for specific reasons.

Q: Should I rest after a Discogel injection into lumbar discs?

A: Sitting exerts the most pressure on lumbar discs among different body positions. The pressure decreases when standing, and conditions are even better when walking. That's why the best posture for individuals who have had a Discogel injection into lumbar discs is either walking or lying down unless the treating physician suggests otherwise. We recommend that our patients avoid sitting for more than five to ten minutes at a time. Over time, and after the first week, you can gradually increase the duration of sitting.

Q: Does pain completely disappear after injecting Discogel?

A: Pain has a very complex mechanism, and multiple factors influence its onset and intensity. The presence and severity of these factors in each individual determine the answer to this question.

It is possible that periodic pains caused by a herniated disc may persist after Discogel injection, but typically, over time, the intensity and duration of these pains diminish.

Q: When does Discogel start to be effective?

A: The function of Discogel begins as soon as it is injected into the damaged disc. However, it's important to remember that checking for monitoring Discogel’s performance or any other method can unconsciously, through psychological mechanisms, increase pain perception and intensity by increasing attention to it.

Q: Do the pains completely disappear immediately after Discogel injections?

A: It's important to remember that Discogel is not a painkiller medication, and during the first few weeks, some level of pain may persist. For this reason, and to manage these pains, pain medications may be prescribed by the physician as needed. Typically, the intensity of these pains gradually decreases over the first three weeks following the injection.

Q: Can I use topical pain creams or heat therapy for my back after Discogel therapy?

A: If there are no allergies or sensitivities, there are no restrictions on using topical pain creams and heat or cold therapy.

Q: Can stress and emotional conditions delay my recovery process after Discogel therapy?

A: Stress, nervous tension, insomnia, and many other factors can not only lower the pain tolerance threshold but also contribute to the emergence or exacerbation of psychosomatic and non-physical pains. Therefore, creating a safe, stress-free environment and avoiding emotional tension will not only enhance the rate and effectiveness of your recovery but also improve your response to treatment.

Q: How many days it will take to cure disc herniation after Discogel injection?

A: The time of recovery and symptom relief can vary among individuals and depend on the duration of the condition and some other factors. most individuals typically experience a reduction in pain a few days after Discogel injection, and significant improvement is usually observed within three to six weeks. however, some patients may require more time for recovery.

Q: What are the results of Discogel?

A: According to the publication: «Journal of Spinal Disorders and Techniques» Oct. 2007 on a percutaneous treatment of lumbar intervertebral hernias, the rate of results is considered very good or good for 91.4 % (group A: 202/221 patients). On patients with complicated hernias which were treated by Discogel (having a narrow channel, a foraminal hernia, a very painful hernia) belonging to group B an automated percutaneous discectomy was additionally practiced. Patients of group C: Discogel was associated with treatment by radio frequency. The hit rate in these two last considered groups as very good or good was 84 % and 82 %.

Q: Do I need to communicate with my doctor after injecting Discogel?

A: In our clinic, the first visit after the injection is done in the recovery room. Essential information about important points is provided to the patient.

A hard copy or online version of the post-Discogel injection care instructions is given to the patient. Depending on the patient's condition, the second visit after the Discogel injection is usually scheduled between the third and seventh day after the injection. During this visit, after conducting a clinical examination, necessary points for enhancing the effectiveness of Discogel are reviewed. The next visit will typically be in the third or fourth weeks after the injection.

Q: When can I get a shower after injecting DiscoGel?

A: The place where DiscoGel is injected into your disc is about the size of a fine needle, and you may not even be able to see it easily! So, even without the need for a waterproof bandage, you can get a shower in the first few hours after the injection and wash the injection site.

Just remember these important points: sudden movements, body rotations, and bending the injection region are not recommended.

Q: How long after injecting DiscoGel into the neck disc can I drive?

A: Driving is allowed at least 3 weeks after injecting DiscoGel into the neck disc, with full caution. Keep in mind that sudden movements and neck rotations are not recommended. Try to use your car's mirrors and cameras more instead of turning your head and neck if needed.

Q: How long after injecting DiscoGel into the back disc can I drive?

A: Starting to drive in patients who have undergone DiscoGel injection into the lower back disc is allowed after 3 to 4 weeks, for short distances and less than twenty minutes. This duration will gradually increase.

Q: Does our sleeping position affect the pressure on the cervical discs?

A: Our sleeping position, the use of pillows, and even the type of pillow we use can have a significant impact on increasing or reducing the pressure on our spinal column. Sleeping on the stomach, using tall and improper pillows, leaving a gap under the neck, and other factors can increase the pressure on the spinal column and cervical discs.

Q: Which sleeping position reduces the pressure on cervical discs?

A: It's better to develop a habit of sleeping on your back and placing a pillow with an appropriate height and softness under your neck, which also supports your head and shoulders. If you cannot sleep on your back for any reason, you can sleep on your side, but make it a habit to regularly change your position from right to left and vice versa.

Q: How should I use a pillow when sleeping on my shoulder?

A: In this case, choose the pillow's height to maintain the alignment of your head and neck with the rest of your spine. Place a suitable pillow in front of your body to support your upper arm, allowing you to rest your arm on it or hug it with both arms.

Q: Can memorable pillows be suitable for us?

A: Memorable pillows can have beneficial effects on reducing spinal problems if they have a design that aligns with the body's anatomy and are used correctly. However, even these pillows should be used properly.

Q: What is the best sleeping position for me?

A: If you have or don't have back pain, the best sleeping position for you is lying on your back. Even in this position, placing a suitable pillow under your knees will reduce the pressure on your spine and lower back discs.

Q: If I can't sleep on my back, what should I do?

A: If sleeping on your back is difficult, you can use the side sleeping position. In this case, make sure to place a suitable pillow between your knees. If you have a shoulder issue, position a pillow in front of it so your upper knee rests on the pillow. For neck support in this position, refer to relevant guidance.

Q: What is the failure rate with Discogel who required surgery?

A: According to the publication only 0.7 % (2/276 patients) requested surgery.

Q: Does Discogel injection cause adhesion of adjacent structures to the disc? And if a patient's disc herniation does not respond well to Discogel injection and requires surgery, will it make the surgery more difficult?

A: Among all the cases treated with Discogel injection at our clinic, three patients required surgery. There were no adhesions or tissue damage in these patients.

Q: Do we need to repeat the Discogel injection?

A: No, based on the five-year period follow-up by the manufacturer and our ten-year patient follow-up, there has been no need to repeat the Discogel injection. Only one of our patients required a repeat injection two years after treatment, due to severe accident-related pain recurrence.

Q: Does the treatment induce an intervertebral disc collapse?

A: This technique does not affect the height of the intervertebral space and the impact on the anatomy of the spine is conserved.

Q: How long is it possible to take back physical activities?

A: The reintegration for physical activity (everything depends on the type of exercise and individuals, but it is almost 3 up to 6 weeks).

Q: After intervention on a cervical disc, is it necessary to carry a surgical collar?

A: No, because it is necessary to re-develop muscles as much as possible in the postural cervical muscles and to induce the resumption of muscular energy in the treated zone by watching not to force during the period of recovery.

Q: Is Discogel injection painful?

A: Discogel injection is typically performed under local anesthesia. In some cases, sedatives may also be used during the injection to reduce the patient's stress. At the beginning of the injection, the patient may experience a transitional scalding sensation in the region of injection which disappears in the course of injection. However, Discogel injection is usually not painful.

Q: Is Discogel injection effective for treating the recurrence of a disc after surgery on the same disc?

A: The effectiveness of Discogel injection for treating the recurrence of a disc after previous surgery is significantly reduced. However, it can be useful and effective for treating adjacent disc herniations near the surgical site.

Q: Should we sit on a chair or a sofa?!

A: The anatomy of our spinal column is designed in a way that it is better for our health to use a chair rather than a sofa for sitting. Slouching and improper body positions during rest can exert pressure on intervertebral discs, facet joints, muscles, tendons, and even nerve roots, potentially leading to pain and more serious issues like intervertebral disc damage or cervical and lumbar joint wear and tear.

Q: Is jump roping good for my lower back discs?

A: Performing beneficial stretches and corrective movements can play an important role in spinal health. However, repetitive and high-impact movements, such as jumping and skipping rope and roping can increase pressure on the joints and discs between the vertebrae. For this reason, such exercises are not recommended, especially for those with spinal issues.

Q: When can I start corrective exercises after a Cervical Discogel injection?

A: Herniated and ruptured discs can lead to severe pain and painful muscle spasms, restricting various activities and movements of local muscles and related limbs. Gradually, this can result in muscle weakness and even tendon shortening. Therefore, starting corrective exercises as early as possible can improve the patient's response to treatment. In our clinic, we teach gentle shoulder and arm, not neck! stretches from the first day after the injection for patients with cervical disc herniation.

Q: When can I start corrective exercises after a Lumbar Discogel injection?

A: We recommend mild walking on flat ground and swimming in warm or moderately heated water to patients undergoing Discogel injection for lumbar disc herniation. From the second week after the Discogel injection, we suggest very light stretching exercises for the muscles in the lower back, and buttocks, and gradual progressive strengthening of the abdominal muscles, depending on the clinical conditions of the patient.

Q: When can I start physiotherapy?

A: In our clinic, in the third week, based on the patient's clinical condition and under the guidance of the treating physician, we refer the patient to an experienced physiotherapist. Physiotherapists, cautiously and in addition to other therapeutic modalities, initiate stretching and strengthening exercises for the lower back, hamstrings, abdomen, and other important muscles for lumbar cases and neck, shoulders, and arms for cervical cases. We emphasize once again that the treatment approach for each patient is selected based on the treating physician's opinion and the individual conditions of each patient.

Q: Is it necessary to stay in touch with my doctor after a Discogel injection?

A: Certainly, maintaining communication with your treating physician and obtaining their instructions for appropriate treatments in various conditions and depending on each patient's circumstances will significantly enhance the success of Discogel therapy.

Q: The presence of tungsten in Discogel doesn't interfere with MRI??

A: No, tungsten is MRI-compatible and is not affected by the magnetic field.

Q: Can I do an MRI after a Discogel injection?

A: Yes, doing an MRI after a Discogel injection is not prohibited.

Q: Is Discogel visible in MRI images?

A: No, Discogel is not visible in MRI images.

Q: Is it necessary to do an MRI after a Discogel injection?

A: Monitoring positive changes resulting from a Discogel injection requires time, and it may take a long time after the procedure for significant changes in the appearance of the disc to be observed. It's like a perforated ball that, despite not appearing to change externally, has reduced air pressure inside!

Q: Will the size of the disc protrusion change after a Discogel injection?

A: Immediately after a Discogel injection, there will be no change in the size of the disc. Based on our experience, in many cases, over time, the size of the protruded disc decreases in MRI, a fact supported by published articles.

Q: What is the best follow-up method for patients after a Discogel injection?

A: Clinical examination is the best follow-up method for patients.

Q: What is the usual imaging follow-up method after a Discogel injection?

A: A plain X-ray can effectively show the presence and distribution of Discogel within the disc.

Q: is it possible for Discogel not to be visible in the plain X-Ray?

A: Due to the presence of tungsten in Discogel, we should typically be able to see it in a plain X-ray

Q: Is Discogel visible in CT scan images?

A: Yes, bone window CT scan views at 2-3 millimeter slices can effectively demonstrate the distribution of discography within the disc and even its penetration into fragmented areas.

Disclaimer: The information provided in this FAQ section is based on the personal experiences of the CSO of our company over the years of using this product. It is solely intended to share these experiences and does not imply any responsibility on the part of our company or the CSO for the analysis and selection of treatment methods. It is essential that relevant specialists, who are engaged in patient care, take responsibility for analyzing and choosing appropriate treatment methods. Our company and its CSO are not liable for the selection of treatment methods or the outcomes obtained.