CT-Guided Radiofrequency Ablation Targeting the Herniation Edge of the Cervical Disc for the Treatment of Neck Pain: A Retrospective Study.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2024-02-01 Epub Date: 2023-11-30 DOI:10.1007/s40122-023-00563-5

Nannan Zhang, Jiaqi Hu, Wenjun Cai, Wenlong Liu, Shun Li, Bin Ru

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引用次数: 0

Abstract

Introduction: Sinuvertebral nerve overactivation is one of the mechanisms of neck pain caused by cervical disc herniation. Radiofrequency ablation (RFA) of sinuvertebral nerves has shown efficacy for the treatment of discogenic low back pain. However, relatively few studies evaluated the efficacy of RFA of sinuvertebral nerves for the treatment of chronic neck pain caused by cervical disc herniation.

Methods: Clinical data were retrospectively collected from 168 patients diagnosed with cervical disc herniated neck pain from January 1, 2019, to September 1, 2022, who were treated with computed tomography (CT)-guided cervical disc RFA of at the Pain Medicine Center of Zhejiang Provincial People's Hospital. A 22-G RFA needle (Inomed, Emmendingen, Germany) was inserted between the carotid artery and trachea to the intervertebral disc under the direction of CT the scanner. Depending on the position of the protruding nucleus pulposus or the rupture of the annulus fibrosus, the needle was inserted into the posterior side of the intervertebral disc until the tip of the needle reached the target position. The numeric rating scale (NRS) score, pain relief and appearance of complications after RFA were evaluated.

Results: A total of 168 patients underwent CT-guided RFA for cervical disc herniation. The average duration of pain was 67.07 ± 70.42 months. At 6 months of follow-up, the median preoperative NRS score decreased significantly from preoperative 5.41 ± 1.08 to postoperative 1.341 ± 1.25 at 1 month, 1.4 ± 1.38 at 3 months and 1.72 ± 1.41 at 6 months after RFA (p < 0.01). The numbers of patients with ≥ 50% of their neck pain relieved were 84% (141/168), 87% (147/168), 87% (147/168) and 79% (133/168) at 1 day, 1 month, 3 months and 6 months after RFA, respectively. No serious complications related to treatment or long-term complications were observed.

Conclusions: This study highlights that CT-guided RFA targeting the edge of cervical disc herniation to destroy the sinuvertebral nerves can effectively relieve neck pain, and the computed tomography (CT)-guided RFA treatment strategy has the advantages of having few complications.

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ct引导下针对颈椎间盘突出边缘射频消融治疗颈部疼痛的回顾性研究。

颈椎神经过度激活是颈椎间盘突出症引起颈部疼痛的机制之一。椎神经射频消融术(RFA)治疗椎间盘源性腰痛疗效显著。然而，相对较少的研究评估椎神经射频消融术治疗颈椎间盘突出症引起的慢性颈部疼痛的疗效。方法:回顾性收集2019年1月1日至2022年9月1日在浙江省人民医院疼痛医学中心行CT引导下颈椎间盘射频消融治疗的168例颈椎间盘突出性颈痛患者的临床资料。在CT引导下，将22g RFA针(Inomed, Emmendingen, Germany)插入颈动脉和气管之间至椎间盘。根据髓核突出的位置或纤维环破裂的情况，将针插入椎间盘后侧，直至针尖到达目标位置。评估RFA后的数值评定量表(NRS)评分、疼痛缓解情况及并发症出现情况。结果:168例患者行ct引导下射频消融治疗颈椎间盘突出症。平均疼痛持续时间67.07±70.42个月。随访6个月时，术前NRS评分中位数从术前的5.41±1.08降至术后1个月的1.341±1.25,3个月的1.4±1.38,6个月的1.72±1.41 (p)。本研究强调，CT引导下RFA针对颈椎间盘突出边缘破坏椎神经，可有效缓解颈部疼痛，CT引导下RFA治疗策略具有并发症少的优点。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.