Unexpected Cervical Cord Injury During Intradiscal Electrothermal Therapy for Disc Herniation
Jun-Yong Cha1, Sangsoo Choi1, Sungbum Kim1
1Department of Neurosurgery, Gangnam Nanoori Hospital, Seoul, Korea.
Korean Journal of Neurotrauma
|February 19, 2025
Summary
Intradiscal electrothermal therapy (IDET) can cause serious spinal cord injury. A patient developed hemiparesis after IDET for cervical disc herniation, highlighting risks and the need for careful patient selection.
Area of Science:
- Neurosurgery
- Pain Management
- Spinal Cord Injury
Background:
- Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment for chronic discogenic pain.
- IDET aims to modify collagen and ablate pain fibers using controlled heat.
- While less invasive than surgery, IDET carries risks including nerve damage and spinal cord injury.
Observation:
- A 36-year-old woman experienced left-sided hemiparesis after IDET for cervical disc herniation at C5/6.
- MRI revealed cervical cord edema, and neurological examination showed deficits in proprioception, motor strength, and sensation.
- Subsequent anterior cervical discectomy and fusion identified thermal injury to the ventral spinal cord.
Findings:
- The patient's hemiparesis was attributed to thermal injury of the cervical spinal cord during IDET.
- Postoperative surgical intervention led to significant neurological improvement.
- Persistent sensory deficits were noted despite recovery.
Implications:
- This case highlights the potential for severe neurological complications from IDET, including spinal cord thermal injury.
- Emphasizes the critical need for careful patient selection and meticulous technique in IDET procedures.
- Suggests reserving IDET for specific indications and considering alternative treatments for complex spinal conditions.
