Like fixing a flat on the roadside, a new injectable hydrogel is showing promise as a remedy for worn-down spinal discs -- pumping them back up and relieving chronic back pain.
The gel, with the brand name Hydrafil, is injected directly into worn discs using X-rays to guide the needle, said lead researcher Dr. Douglas Beall, chief of radiology services at Clinical Radiology of Oklahoma in Edmond. As outlined in a pilot study,. The gel fills in cracks and tears in the spinal disc, adhering to the disc's center and outer layer.
"It goes in as a heated liquid that cools off and becomes kind of the consistency of a medium hard eraser," Beall said. "It creates kind of a Fix-a-Flat, filling the disc back up and returning the biomechanical integrity of the disc."
Twenty patients treated with the gel experienced a 67% reduction in their back pain during a one-year follow-up, Beall said.
The patients also experienced an 85% improvement in disability caused by their back pain. Beall said the gel caused no harmful reactions in any of the patients.
The bones in your spinal column -- the vertebrae -- are separated by rubbery cushions called spinal discs. These discs act as shock absorbers, preventing the vertebrae from rubbing together and allowing you to move, bend and twist comfortably.
Degenerative disc disease occurs as people age. Spinal discs tend to dry out and wear away over time. They also can be torn or injured as a result of daily activities or sports.
By Beall's estimates, as many two-thirds of people with back pain caused by degenerative disc disease could be considered candidates for this hydrogel therapy.
He is scheduled to present these findings Sunday in Boston at a meeting of the Society of Interventional Radiology. Findings presented at meetings are considered preliminary until published in a peer-reviewed journal.
Hydrafil was designated as a breakthrough device in 2020 by the U.S. Food and Drug Administration, which allows expedited review when evidence suggests an experimental product could provide more effective treatment for a serious condition compared to current options, researchers said.
Other hydrogels already are being used to treat injured or worn discs, but those products are inserted surgically as a soft solid, "which can pop out of place if you're not highly skilled in placing it," Beall said.
"Because this gel is injectable, it requires no incision, and it augments the whole disc, restoring its structural integrity, which nothing we have currently can do," he said.
Dr. J. David Prologo, an interventional radiologist at Emory University School of Medicine in Atlanta, reacted to the findings.
"The impact of this study I don't think can be overstated -- degenerated disc disease is a condition that affects hundreds of millions of people worldwide, for which there is really no definitive treatment other than a big surgery, with all of the associated costs and risks," he said.
"Dr. Beall is spearheading the ability to literally inject a liquid replacement to the disc using only a needle and image guidance, removing the needle after the injection and sending the patient home with a replaced disc and Band-Aid over the puncture site," said Prologo, who chairs the Society for Interventional Radiology's Pain Management/MSK Clinical Specialty Council.
Dr. Alan Hilibrand, co-director of spinal surgery at the Rothman Orthopaedic Institute in Philadelphia, agreed.
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