[Intradiscal electrothermal treatment combined with epidural steroid injection for discogenic lumbago-leg pain].

OBJECTIVE: To assess the effectiveness of intradiscal electrothermal treatment (IDET) combined with epidural steroid injection for discogenic lumbago-leg pain. METHODS: Fifty-nine patients with discogenic lower back pain and radical pain underwent IDET and CT guided spinal cord epidural steroid injection (Limethason). Thirty-eight patients with discogenic lower back pain and radical pain underwent IDET only. The clinical efficacy was observed within 1 week, 1 week-1 month, 1 - 3 months, and 3 - 6 months after the treatment. RESULTS: The efficacy rates within 1 week, 1 week-1 month, 1 - 3 months, and 3 - 6 months after the treatment of the IDET plus epidural steroid injection group were 71%, 55%, 81%, and 89% respectively, and those of the IDET only group were 55%, 34%, 76% and 87% respectively. The efficacy rate 1 week-1 month postoperatively of the IDET plus epidural steroid injection group was significantly higher than that of the IDET only group (chi(2) = 4.375, P < 0.05), and the efficacy rates at other time points were not significantly different between these 2 groups. CONCLUSION: IDET combined with epidural steroid injection relieves post-IDET edema and induces pain more effectively.

[Dual interventional therapy for malignant gastroduodenal obstruction].

BACKGROUND & OBJECTIVE: The patients with malignant gastroduodenal obstruction usually have unresectable primary lesion and distant metastasis. Intra-luminal metallic stent implantation followed by intra-arterial chemotherapy via the tumor feeding arteries, so-called "dual interventional therapy", could temporarily relieve obstructive symptoms. This study was to evaluate the clinical safety and efficacy of dual interventional therapy on advanced malignant gastroduodenal obstruction. METHODS: A total of 65 patients with malignant gastroduodenal obstruction underwent dual interventional therapy. Of the 65 patients, 33 had pyloric antrum obstruction, 22 had duodenal obstruction, and 10 had gastroduodenal obstruction with gastrojejunostomal obstruction; 9 had liver metastasis. The patients' survival was analyzed by log-rank test. RESULTS: Stents were successfully implanted into all enrolled patients. No severe adverse events were observed in these patients. The cumulative survival rates at 3, 6, 9, and 12 months after dual interventional therapy were 90%, 66%, 49%, and 28%, respectively. The median survival time was 11.9 months. CONCLUSION: The dual interventional therapy, with metallic stent implantation to relieve malignant obstruction and high-selective intra-arterial chemotherapy to control tumor growth, is a safe, feasible and effective treatment for malignant gastroduodenal obstruction.