Coblation annuloplasty in cervical discogenic pain without radiculopathy.

Abstract

Introduction: The nerve fibers innervating the annulus fibrosus are the major origin of degeneration-associated discogenic pain. Coblation is a tissue-dissociating technique in which the nerve fibers in the degenerative disc tissue are ablated. We hypothesized that coblation annuloplasty would be an effective maneuver for cervical discogenic pain without radiculopathy. Aim: To observe the therapeutic efficacy of coblation annuloplasty in patients with cervical discogenic pain without radiculopathy. Material and methods: Forty patients diagnosed with cervical discogenic pain without radiculopathy were screened for coblation annuloplasty therapy. The patient-rated visual analog scale (VAS) score for pain, significant pain relief rate, and Modified MacNab pain-relieving effect were adopted to evaluate the therapeutic effect within a 1-year follow-up period. Results: Thirty-three patients eventually completed the study. The average pain duration was 4.6 ±1.6 years (range: 0.5-8 years). The mean VAS pain score decreased from preoperative 6.8 ±0.9 to postoperative 2.5 ±1.3 (p < 0.01). For all participants, the immediate pain relief rate was 78.7% (26/33), which continued to postoperative 6 months. One year later, 22 (66.6%) subjects reported that their pain was significantly alleviated. According to the Modified MacNab criteria, 63.6-82.1% considered the effect of surgery for their pain therapy as "excellent" during the 1-year follow-up period. No significant complications such as hemorrhage, paresthesia, or infection were observed. Conclusions: This study is the first to demonstrate that coblation annuloplasty is an effective intervention providing significant alleviation of neck pain from cervical discogenic injury without radiculopathy.

Application of a new anatomic hook-rod-pedicle screw system in young patients with lumbar spondylolysis: A pilot study

“…The measures were recorded preoperatively and 3, 6, 12 and 24 mo after surgery. Functional status was qualified as “excellent,” “good,” “fair” and “poor” according to the Modified Macnab criteria[ 19 ] and recorded at 3, 6, 12 and 24 mo postoperatively.…”

Increased Expression of Inflammatory Cytokines and Discogenic Neck Pain

“…However, recent studies have shown that intervertebral discs, particularly degenerative ones, have extensive innervation. 8 In 1988, Bogduk et al described the innervation patterns of the sinuvertebral nerves into the outer third of the annulus fibrosis based on microdissection and histologic studies from clinical patients and cadavers. 10 Their research also demonstrated the presence of nerve fibers and nerve endings within the outer third of the annulus fibrosis using cholinesterase staining.…”

“…Scholars once thought that the intervertebral disc was not innervated; therefore, the diagnosis of discogenic pain was controversial. However, recent studies have shown that intervertebral discs, particularly degenerative ones, have extensive innervation 8 . In 1988, Bogduk et al .…”