Morphometrical and Clinical Analysis of Cervical Nucleoplasty Cases Using Coblation Technique

Hamit Selim Karabekir,Nuket Gocmen Mas,Ayse Canan Yazici,Elmas Atar,Ahmet Yildizhan,Nilufer Demirci Yonguc

doi:10.21767/2471-8173.100021

Hamit Selim Karabekir, Nuket Gocmen Mas + Show 4 more

Open Access

https://doi.org/10.21767/2471-8173.100021

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Abstract

Background: Nucleoplasty is a minimally invasive procedure for managing chronic discogenic cervical pain. We aimed to evaluate the outcomes of nucleoplasty treatment on chronic cervical discogenic pain, intervertebral disc volumetry so as to examine the success of the surgery. Methods: Records of patients who underwent nucleoplasty from two different university hospitals in Turkey were assessed. Records between 2005 and 2014 years of thirty-six cases, who had no recovery from medical and physical treatment and treated with nucleoplasty at single or double levels investigated retrospectively. All assessments included visual analog scale (VAS) evaluation before the surgery and at 6, 12, 24 and 36 months after the surgery. Intervertebral disc volumes between 4th and 5th cervical vertebrates and also between 5th and 6th were measured on axial magnetic resonance images slices using a stereological method, before and after the treatment. Results: VAS results displayed pain improvement at 6, 12, 24 and 36 months after the surgery when compared with that of before the surgery (ps<0.05). After the nucleoplasty treatment, the mean intervertebral disc volumes between 4th and 5th, and also between 5th and 6th cervical vertebrates revealed significant decrease when compared with that of preoperative assesment (ps<0.05). The present study does not compare the results of different techniques used in the disc protrusion management. Conclusions: Good classified patients may have good prognosis with nucleoplasty. The method is minimally invasive, provides a safer surgical experience and has protective effects on intervertebral disc biomechanics.

Highlights

Cervical pain is usually the result of a complex interplay of biochemical and biomechanical processes
Disc herniation has been defined as displacement of the nucleus pulposus
We evaluated all the visual analog scale (VAS) values of the thirty six patients (16 males, 20 females) before and after the surgery without considering the sides and the levels of the disc herniations

Summary

Introduction

Cervical pain is usually the result of a complex interplay of biochemical and biomechanical processes. Internal disc disruption and disc heniations are common causes of cervical and/or upper extremity pain which may become chronic if not diagnosed and treated on time. Annular tears lead to migration of the nuclear contents and derange internal architecture. In the chronically injuried intervertebral disc, leakage of nuclear contents from annular tears may initiate, induce, and continue the inflammatory episode and delay or stop improvement of vital remaining intradiscal tissue [1]. Sensitization of the central nevous system has been suggested to be a possible causative factor of chronicity in some cervical pain conditions. Nucleoplasty is a minimally invasive procedure for managing chronic discogenic cervical pain. We aimed to evaluate the outcomes of nucleoplasty treatment on chronic cervical discogenic pain, intervertebral disc volumetry so as to examine the success of the surgery

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