Cervical intradiscal radiofrequency lesioning: a feasiblity study

Area of Science:

• Orthopedics
• Neurosurgery
• Pain Management

Background:

• Cervical disc pain is a common condition.
• Intradiscal radiofrequency (RF) is a potential treatment for discogenic pain.
• Effective denervation requires adequate heating of the entire intervertebral disc.

Purpose of the Study:

• To determine if single-site, long-duration intradiscal RF can achieve sufficient heating throughout the cervical intervertebral disc.
• To assess the potential for ablating intradiscal nociceptors using this method.

Main Methods:

• Benchtop study using disarticulated cervical spines from four fresh frozen cadavers.
• Intradiscal RF lesioning at 85°C for 10 minutes in the middle or posterior disc.
• Temperature measurements using thermocouples at three disc locations (middle, posterolateral, anterior third).

Main Results:

• RF lesioning in either the middle or posterior disc failed to generate sufficient temperature increases throughout the entire cervical disc.
• The thermal profile achieved was too focal to ensure adequate denervation.

Conclusions:

• Single-site, long-duration intradiscal RF in the cervical spine produces a focal thermal distribution.
• This technique is insufficient for effective cervical disc denervation.
• Intradiscal RF lesioning is not recommended for in vivo cervical disc denervation.