OBJECTIVE: To examine the potential of etanercept, a biological inhibitor of @entity5 @entity39 factor-alpha ( @entity310 ), delivered by perispinal administration, for the treatment of @entity158 associated with @entity1798 . METHODS: Charts from 20 selected @entity1 treated at our private clinic by perispinal delivery of etanercept 25 mg for severe, chronic, treatment-resistant discogenic @entity158 were reviewed. Therapeutic benefit was assessed clinically and was documented by changes in a validated @entity158 instrument, the @entity717 Index. The @entity1 were treated off-label with etanercept as part of our usual practice of medicine. Five detailed case reports are presented, including three additional @entity1 . RESULTS: Rapid, substantial and sustained clinical @entity158 reduction was documented in this selected group of @entity1 . The cohort of 20 @entity1 had a mean age of 56.5 and mean duration of @entity158 of 116 months. Nine of the @entity1 had undergone previous spinal surgery; 17 had received an epidural @entity134 injection or injections (mean 3.2). This group of @entity1 received a mean of 1.8 doses (range 1-5, median 1.0) of etanercept during the observation period. The mean length of follow-up was 230 days. Clinical improvement was confirmed by a decrease in the calculated @entity717 Index from a mean of 54.85 +/- 12.5 at baseline, improving to 17.2 +/- 15.3 (p <0.003) at 24 days and ending at 9.8 +/- 13 (p <0.003) at 230 days. CONCLUSIONS: @entity310 inhibition by etanercept delivered by perispinal administration may offer clinical benefit for @entity1 with chronic, treatment-resistant discogenic @entity158 . Further study of this new treatment modality is warranted.

Perispinal @entity310 inhibition for discogenic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumour'] @entity310 :: ('7124', 'Gene') :: ['TNF'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity717 :: ('MESH:D009069', 'Disease') :: ['Oswestry Disability'] @entity1798 :: ('MESH:C535531', 'Disease') :: ['intervertebral disc disease']
@entity158 :: (MESH:D010146,Disease) :: ['pain']
