Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
Unità Operativa di Radiologia Diagnostica e Interventistica, ASST Santi Paolo e Carlo, Polo Ospedaliero San Paolo, Università degli studi di Milano, Via Antonio di Rudinì 8, 20142, Milan, Italy.
Radiol Med. 2021 Jun;126(6):860-868. doi: 10.1007/s11547-021-01336-w. Epub 2021 Feb 23.
To confirm the validity of coblation nucleoplasty in reduction of cervical discogenic nature.
In a monocentric prospective clinical observational study recruiting 20 patients, treated with percutaneous coblation for cervical discogenic pain in 16 months in our hospital, we have clinically evaluated 18 patients. The pain was scored with the Visual Analogic Scale (VAS) in a pre-procedural questionary, 3/4 monthly follow-up from treatment and, finally, in a long-term follow-up 2 years after procedure.
The mean pre-procedural VAS score was 7.9 ± 1.6 (95%-Confidence Interval 7.198-8.634), while the mean post-procedural score after 3-4 months has been 2.5 ± 3.1 (95%-Confidence Interval 1.089-3.965) and 2.5 ± 2.5 (95%-Confidence Interval 1.367-3.687) after 2 years. Among 18 patients, in the shortly post-treatment follow-up, nine had a complete pain relief, four had a > 50% VAS reduction, two hada < 50% VAS reduction, three did not have any variation of VAS; after 2 years, six patients had a total pain resolution, eight had a > 50% VAS reduction, two hada < 50% VAS reduction, two did not have any benefit. No peri- and post-procedural complication has been observed.
In a spite of a little sample, our results showed coblation as a valid therapeutic option to reduce cervical discogenic pain in medicine-refractory patients, as an alternative or a previous choice before a more invasive surgical treatment.
证实低温射频消融髓核成形术治疗颈椎间盘源性疼痛的有效性。
在一项单中心前瞻性临床观察研究中，我们招募了 20 名在我院接受经皮低温射频消融术治疗颈椎间盘源性疼痛的患者，其中 18 名患者接受了临床评估。在术前问卷调查中，使用视觉模拟评分法（VAS）对疼痛进行评分，在治疗后 3/4 个月进行随访，最后在 2 年的长期随访中进行评估。
术前 VAS 平均评分为 7.9±1.6（95%置信区间为 7.198-8.634），而术后 3-4 个月的平均评分降至 2.5±3.1（95%置信区间为 1.089-3.965），2 年后降至 2.5±2.5（95%置信区间为 1.367-3.687）。在 18 名患者中，在短期随访中，9 名患者疼痛完全缓解，4 名患者 VAS 评分降低超过 50%，2 名患者 VAS 评分降低小于 50%，3 名患者 VAS 无任何变化；2 年后，6 名患者疼痛完全缓解，8 名患者 VAS 评分降低超过 50%，2 名患者 VAS 评分降低小于 50%，2 名患者无任何获益。未观察到围手术期和术后并发症。
尽管样本量较小，但我们的结果表明，低温射频消融术是治疗药物难治性颈椎间盘源性疼痛的有效治疗选择，可作为更具侵袭性手术治疗的替代或首选方法。
