Kwak So Young, Chang Min Cheol
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
Medicine (Baltimore). 2018 Apr;97(16):e0509. doi: 10.1097/MD.0000000000010509.
Despite medication, exercise, and medical intervention, many patients complain of persistent discogenic neck pain. To manage discogenic neck pain, we performed intradiscal pulsed radiofrequency (PRF) stimulation in a patient with chronic discogenic neck pain refractory to oral medication and epidural steroid injection.
A 26-year-old man presented with a numeric rating scale (NRS) score of 7 for chronic neck pain. His pain was worse when the neck was held in one position for a prolonged period. There was no pain in the upper extremities.
Discography was positive at C4-5. Based on the pain characteristics, and the result of discography, we diagnosed him as having discogenic neck pain originating from C4-5.
Intradiscal PRF on the C4-5 intervertebral disc was performed under C-arm fluoroscopy. The PRF treatment was administered at 2 Hz and a 20-ms pulsed width for 20 minutes at 60 V with the constraint that the electrode tip temperature should not exceed 42°C.
At the 2-week, and 1-month follow-up visits, the patient's pain was completely relieved. At 2, and 3 months after intradiscal PRF, the pain was scored as NRS 2. No adverse effects of intradiscal PRF stimulation were observed.
Application of intradiscal PRF appears to be an effective and safe technique for treating chronic discogenic neck pain.
尽管采用了药物、运动和医学干预措施，但许多患者仍抱怨存在持续性椎间盘源性颈部疼痛。为了治疗椎间盘源性颈部疼痛，我们对一名口服药物和硬膜外类固醇注射治疗无效的慢性椎间盘源性颈部疼痛患者进行了椎间盘内脉冲射频（PRF）刺激。
一名26岁男性，慢性颈部疼痛的数字评分量表（NRS）评分为7分。当颈部长时间保持在一个位置时，他的疼痛会加重。上肢无疼痛。
C4-5椎间盘造影呈阳性。根据疼痛特征和椎间盘造影结果，我们诊断他患有源自C4-5的椎间盘源性颈部疼痛。
在C形臂荧光透视引导下，对C4-5椎间盘进行椎间盘内PRF治疗。PRF治疗以2赫兹的频率、20毫秒的脉冲宽度、60伏的电压进行20分钟，同时限制电极尖端温度不超过42°C。
在2周和1个月的随访中，患者的疼痛完全缓解。在椎间盘内PRF治疗后2个月和3个月时，疼痛评分为NRS 2分。未观察到椎间盘内PRF刺激的不良反应。
椎间盘内PRF应用似乎是治疗慢性椎间盘源性颈部疼痛的一种有效且安全的技术。
