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An Z, Fan G, Su W, Chen C, Lai T, Dong L. Evaluation of the efficacy and safety of day surgery for cervical disc herniation treated with low temperature plasma radiofrequency ablation. INTERNATIONAL ORTHOPAEDICS 2024; 48:211-219. [PMID: 37668729 DOI: 10.1007/s00264-023-05955-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE The purpose of this study was to evaluate and compare the clinical efficacy of patients with cervical disc herniation (CDH) treated by low-temperature plasma radiofrequency ablation (LTP-RFA) as day surgery with traditional inpatients. METHODS According to the selection criteria, single-segment mild to moderate CDH patients who received LTP-RFA from January 2020 to December 2021 were divided into day surgery procedure (DSP) group and a traditional inpatient procedure (TIP) group. The visual analogue score (VAS) and modified Japanese Orthopedic Association score (mJOA) of neurological function of patients in the two groups were recorded at the time of preoperative, and one day, three months, six months after surgery and the last follow-up respectively. The gender, age, responsible segment, surgical complications, hospitalization time, hospitalization expenses, and patient satisfaction were recorded and analyzed for both groups. The modified Macnab standard was used to evaluate the postoperative efficacy at one month and six months after operation. RESULTS A total of 127 patients (75 in DSP;52 in TIP) with complete data were enrolled and completed six month follow-up. There were no statistically significant pre-treatment VAS scores and mJOA scores in the two groups (P>0.05). The postoperative VAS and mJOA scores in both groups were improved after surgery (P<0.05). However, there was no significant difference in VAS scores and mJOA scores between the two groups in the same postoperative period (all P > 0.05). The efficacy of MacNab was similar one month and six months after operation (P > 0.05). The hospitalization time and hospitalization cost were significantly lower in DSP group (all P<0.05). As the treatment effects were comparable, patients in both groups were similarly satisfied at discharge. CONCLUSION LTP-RFA is an effective method for the treatment of mild to moderate CDH. We suggest that the application of LTP-RFA in DSP for mild to moderate CDH is worthy of wide application.
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Affiliation(s)
- Zhongcheng An
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
| | - Guangya Fan
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
| | - Wenshuo Su
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
| | - Chen Chen
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
| | - Tingyuan Lai
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China
| | - Liqiang Dong
- Department of Orthopedics and Traumatology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, People's Republic of China.
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He LL, Lai RJ, Leff J, Yuan R, Yue JN, Ni JX, Yang LQ. Cervicogenic dizziness alleviation after coblation discoplasty: a retrospective study. Ann Med 2021; 53:639-646. [PMID: 33855907 PMCID: PMC8057077 DOI: 10.1080/07853890.2021.1910336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Little is known about the therapeutic relationship between coblation discoplasty and cervicogenic dizziness (CGD). CGD can be caused by abnormal proprioceptive inputs from compressed nerve roots, intradiscal mechanoreceptors and nociceptors to the vestibulospinal nucleus in the degenerative cervical disc. The aim was to analyze the efficacy of coblation discoplasty in CGD through intradiscal nerve ablation and disc decompression in a 12-month follow-up retrospective study. METHODS From 2015 to 2019, 42 CGD patients who received coblation discolplasty were recruited as the surgery group, and 22 CGD patients who rejected surgery were recruited as the conservative group. Using intent-to-treat (ITT) analysis, we retrospectively analyzed the CGD visual analogue scale (VAS), neck pain VAS, CGD frequency score, and the CGD alleviation rating throughout a 12-month follow-up period. RESULTS Compared with conservative intervention, coblation discoplasty revealed a better recovery trend with effect sizes of 1.76, 2.15, 0.92, 0.78 and 0.81 in CGD VAS, and effect sizes of 1.32, 1.54, 0.93, 0.86 and 0.76in neck pain VAS at post-operative 1 week, and 1, 3, 6, 12 months, respectively. The lower CGD frequency score indicated fewer attacks of dizziness until postoperative 3 months (p < 0.01). At post-operative 12 months, the coblation procedure showed increased satisfactory outcomes of CGD alleviation rating (p < .001, -1.00 of effect size). CONCLUSIONS Coblation discoplasty significantly improves the severity and frequency of CGD, which is important inbridging unresponsive conservative intervention and open surgery.Key messagesThere is a correlation between the degenerative cervical disc and cervicogenic dizziness (CGD).CGD can be caused by abnormal proprioceptive inputs from a compressed nerve root and intradiscal mechanoreceptors and nociceptors to the vestibulospinal nucleus in the degenerative cervical disc.Cervical coblation discoplasty can alleviate CGD through ablating intradiscal nerve endings and decompressing the nerve root.
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Affiliation(s)
- Liang-liang He
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ru-jing Lai
- Department of Anesthesiology, Longyan First Hospital, Affiliated to Fujian Medical University, Longyan City, Fujian, China
| | | | - Rong Yuan
- Ultrasonic Diagnosis Department, North District of Peking University Third Hospital, Beijing, China
| | - Jian-ning Yue
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jia-xiang Ni
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li-qiang Yang
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
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He L, Zhao W, Yue L, Rich L, Yue J, Ni J, Yang L. Coblation Discoplasty Alleviates Cervical Chest Pain After Positive Ultrasound-Guided Nerve Root Block: A Retrospective Study. World Neurosurg 2021; 151:e927-e934. [PMID: 33991730 DOI: 10.1016/j.wneu.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cervical chest pain (CCP), as 1 atypical symptom associated with cervical spondylosis, often overlaps with other chest-related diseases. CCP obviously relieved after ultrasound-guided cervical nerve root block near a herniated disc should be considered as a potential pathologic source. The purpose of this study is to investigate whether coblation discoplasty can alleviate CCP after positive ultrasound-guided nerve root block. METHODS From August 2016 to September 2019, 21 patients with high suspicion of CCP experienced over 50% pain relieve after ultrasound-guided diagnostic nerve root block. Through 12 months of follow-up, the primary efficacy was assessed with visual analogue scale (VAS) of CCP, and secondary outcomes included: neck pain VAS, neck disability index (NDI), the proportion of significant CCP relief, the rating of CCP alleviation, the patient satisfaction index (PSI), and analgesic consumption. Adverse events were recorded to evaluate safety. RESULTS Following postoperative 12 months, a time-course analysis confirmed a robust decline in VAS of CCP (P < 0.0001), and a similar recovery trend was shown in VAS of neck pain and NDI (P < 0.0001). After treatment, the number of patients taking analgesics decreased (P < 0.0001), and around 60% of patients reported notable relief and satisfaction with treatment. No serious complications were observed. CONCLUSIONS After positive ultrasound-guided nerve root block, coblation discoplasty can provide up to 12 months of relief for intractable CCP.
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Affiliation(s)
- Liangliang He
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wenxing Zhao
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Yue
- Department of Pain Management, Changzhou Cancer Hospital, Changzhou, China
| | - Liang Rich
- Center for Cerebrovascular Research, University of California, San Francisco, California, USA
| | - Jianning Yue
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiaxiang Ni
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liqiang Yang
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.
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Wu B, Yue L, Sun F, Gao S, Liang B, Tao T. The Feasibility and Efficacy of Ultrasound-Guided C2 Nerve Root Coblation for Cervicogenic Headache. PAIN MEDICINE 2020; 20:1219-1226. [PMID: 30561695 DOI: 10.1093/pm/pny227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The cervicogenic headache is a syndrome caused by dysfunction of the upper cervical spine and its component bony, disc, and/or soft tissue elements. The C2 nerve root may play a pivotal role in cervicogenic headache. In this retrospective study, we evaluated the feasibility and efficacy of ultrasound-guided C2 nerve root coblation in managing 26 patients with cervicogenic headache. DESIGN AND SETTING The data were collected retrospectively by reviewing the patient's medical records and pain questionnaires. SUBJECTS AND METHODS A total of 109 patients with cervicogenic headache sustained for at least six months were identified. Of those patients, 26 had a visual analog scale score ≥6 and subsequently underwent an ultrasound-guided C2 nerve root coblation. RESULTS All 26 patients had >50% pain relief one day after coblation. Twenty-three of the 26 patients (92.31%) had a decrease in their pain score of 50% or more at 24-week follow-up. The mean pain score was 7.38 ± 1.13 before coblation and 1.85 ± 0.83 one day after coblation (Bonferroni-adjusted P < 0.001). At 12 and 24 weeks after coblation, the mean pain scores were 2.96 ± 0.96 (P < 0.001) and 3.08 ± 1.38 (P < 0.008), respectively. CONCLUSIONS C2 nerve coblation may provide the majority of patients with a pain relief period as long as 24 weeks. And ultrasound guidance is an efficient method with which to perform coblation.
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Affiliation(s)
- Baishan Wu
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Yue
- Department of Anesthesiology, Changzhou Tumor Hospital, Changzhou, Jiangsu, China
| | - Fenglong Sun
- Department of Orthopedics, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Capital Medical University, Beijing, China
| | - Shan Gao
- Department of Acupuncture & Moxibustion, Wuhan Hospital of Integrated Chinese & Western Medicine, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Bing Liang
- Department of Anesthesiology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Tao Tao
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Anesthesiology, Central People's Hospital of Zhanjiang, Zhanjiang, China
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Peng B, Bogduk N. Cervical Discs as a Source of Neck Pain. An Analysis of the Evidence. PAIN MEDICINE 2019; 20:446-455. [PMID: 30520967 DOI: 10.1093/pm/pny249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVESBACKGROUND Objectives To determine the extent and strength of evidence that supports the belief that cervical intervertebral discs are a source of neck pain. DESIGN Design The evidence from anatomical, laboratory, experimental, diagnostic, and treatment studies was summarized and analyzed for concept validity, face validity, content validity, and construct validity. RESULTS Results Evidence from basic sciences shows that cervical discs have a nociceptive innervation, and experimental studies show that they are capable of producing neck pain. Disc stimulation has been developed as a diagnostic test but has rarely been used in a disciplined fashion. The prevalence of cervical disc pain has not been properly established but appears to be low. No treatment has been established that reliably achieves complete relief of neck pain in substantial proportions of patients. CONCLUSIONS Conclusions Basic science evidence supports the concept of cervical disc pain, but epidemiologic and clinical evidence to vindicate the clinical application of the concept is poor or lacking.
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Affiliation(s)
- Baogan Peng
- Department of Spinal Surgery, Institute of Spinal Surgery of Armed Police Force, General Hospital of Armed Police Force, Beijing, Peoples Republic of China
| | - Nikolai Bogduk
- Faculty of Medicine and Health Sciences, The University of Newcastle, Newcastle, Australia
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Li X, Yang L, Ni J, Zhang Y. Four-year pain relief after coblation combined with active exercise for cervical discogenic pain: Case report. Medicine (Baltimore) 2019; 98:e16409. [PMID: 31305455 PMCID: PMC6641694 DOI: 10.1097/md.0000000000016409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
RATIONALE Coblation of intervertebral disc is an effective and safe minimally invasive technology for treating discogenic pain. The inactivation of neural ingrowth around annulus and tissue ablation and coagulation are currently considered to be the major causes for success of this treatment. However, it has been found by clinical researchers that its long-term clinical outcome is not optimistic. This report has given us favorable information that this situation can be improved with multimodal therapy. PATIENT CONCERNS A 61-year-old man presented with right severe neck and shoulder pain in 2014 which could not be relieved by medications. DIAGNOSES According to his symptoms and signs, this patient was diagnosed with cervical discogenic pain. And discography confirmed the diagnosis. INTERVENTIONS The patient underwent coblation of cervical intervertebral disc 4-5 (C4-5) and got apparently pain relief after surgery. After 1 month, he began to perform active exercise at least 30 min every day. OUTCOMES The right neck and shoulder pain completely relieved for 4 years. The cervical lordosis of this patient was restored in 2018 which was confirmed by MRI compared in 2014 and NDI (neck disability index) decreased from 58 to 10%. LESSONS This report demonstrated that it was important and essential for clinicians to educate patients with discogenic pain to perform active exercise after minimally invasive surgery.
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Affiliation(s)
- Xiuhua Li
- School of Medicine, Tsinghua University, Haidian District
| | - Liqiang Yang
- Department of Pain Management, Xuanwu Hospital of Capital Medical University
| | - Jiaxiang Ni
- Department of Pain Management, Xuanwu Hospital of Capital Medical University
| | - Yuqi Zhang
- Clinical Neuroscience Institute, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, P.R. China
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Abstract
RATIONALE 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. PATIENT CONCERNS 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. DIAGNOSES 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. INTERVENTIONS 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. OUTCOMES 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. LESSONS Application of intradiscal PRF appears to be an effective and safe technique for treating chronic discogenic neck pain.
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Liguori A, Galli F, Gurgitano M, Borelli A, Pandolfi M, Caranci F, Magenta Biasina AM, Pompili GGM, Piccolo CL, Miele V, Masciocchi C, Carrafiello G. Clinical and instrumental assessment of herniated discs after nucleoplasty: a preliminary study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:220-229. [PMID: 29350650 PMCID: PMC6179072 DOI: 10.23750/abm.v89i1-s.7025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM The therapy for low back pain boasts different approaches; one of these is nucleoplasty. We wanted to assess the effectiveness of nucleoplasty both by clinical response both by MR imaging evaluation, including even extrusions larger than one third of the spinal canal. METHODS Fifty-seven patients were treated with nucleoplasty in our hospital, 11 of these patients accepted both clinical and MRI evaluation after six months from treatment. The clinical evaluation was performed with Visual Analogue Scale (VAS) of pain, scored before and after the procedure. MRI evaluation consisted of analysing some imaging parameters of disc protrusions before and after the treatment. RESULTS In 10 out of 11 (91%) patients, VAS was reduced and only 1 out of 11 (9%) had the same pain after procedure. The mean of decrease of VAS score was 64%. In our population 8/11 (72%) patients had a herniation larger than 1/3 of the sagittal diameter of spinal canal and 100% of them had an improvement with a mean VAS reduction value of 75%. With MRI evaluation, the mean percentage of expulsion before and after treatment was respectively 40% and 34%. The expulsion decreased in 7/13 discs, remained equal in 4/13, and increased in 2/13 discs. Among the 9 larger protrusions, 3 didn't change, 6 reduced with a decrease mean value of 13%. Other MRI parameters didn't change significantly. CONCLUSIONS Our preliminary experience supports the success of coblation on pain relief, aiming to show progressively that this treatment is suitable even in case of great extrusions, which are generally treated only with surgical approach. It's not clear the usefulness of MRI control yet, even if in most of cases we could have found a certain reduction of expulsion degree.
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Yang LQ, Gong WY, Wang XP, Dou Z, Zeng YJ, Ni JX. Computed Tomography-Guided Percutaneously Controlled Ablation of the Thoracic Paravertebral Nerve Due to Thoracic Neuropathic Pain. Pain Pract 2017; 17:792-799. [PMID: 27717281 DOI: 10.1111/papr.12527] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/27/2016] [Accepted: 09/04/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Li-Qiang Yang
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Wei-Yi Gong
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Xiao-Ping Wang
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Zhi Dou
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Yuan-Jie Zeng
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Jia-Xiang Ni
- Department of Pain Management; Xuanwu Hospital; Capital Medical University; Beijing China
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Abstract
RATIONALE Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs. PATIENT CONCERNS Patients 1 and 2 presented with a numeric rating scale (NRS) score of 7 and 6 for chronic cervical radicular pain, respectively, despite undergoing monopolar PRF and 2 TFESIs. DIAGNOSES On cervical magnetic resonance imaging, foraminal stenosis at the right C6-7 and right central to right foraminal disc protrusion on C6-7 were observed in patients 1 and 2, respectively. Two patients showed a positive response on diagnostic right C7 selective nerve root block with 0.5 mL of 1% lidocaine. INTERVENTIONS Bipolar PRF stimulation was performed under C-arm fluoroscopy. Two parallel RF cannulas (less than 1 cm apart) were used for DRG stimulation. The PRF treatment was administered at 5 Hz and a 5-ms pulsed width for 360 seconds at 45 V with the constraint that the electrode tip temperature did not exceed 42°C. OUTCOMES At the 2-week and 1-month follow-up, after undergoing bipolar PRF, the pain of patient 1 was completely relieved, and at 2, 3, and 6 months, the pain was scored as NRS 2. In patient 2, at the 2-week follow-up after undergoing bipolar PRF, pain severity was reduced from NRS 6 to 2. The effect of bipolar PRF on patient 2 lasted for at least 6 months. No adverse effects were observed in either patient. LESSONS Application of bipolar PRF to DRGs seems to be an effective and safe technique for treating refractory chronic cervical radicular pain.
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He L, Yue J, Yang L, Wu B, Cao G, Guo Y, Lai G, Tang Y, Ni J. Cervicogenic headache alleviation after cervical coblation nucleoplasty: A prospective cohort study. Medicine (Baltimore) 2016; 95:e4786. [PMID: 27684803 PMCID: PMC5265896 DOI: 10.1097/md.0000000000004786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty.The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches.In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L. Cervicogenic pain was diagnosed according to the International Headache Society criteria. During the 24-month follow-up, pain visual analog scale (VAS) scores were collected as the primary outcomes, and significant pain relief rate, Neck Disability Index (NDI) headache scores, and Patients Satisfaction Index (PSI) scores were recorded as secondary outcomes to evaluate headache severity and physical function postoperatively.During the 24-month follow-up, a significant decrease in headache VAS scores was observed in group C but not in group L. NDI and PSI scores in group C were better than those in group L. In comparison with the final follow-up, no significant differences in the NDI and PSI scores were found in all observations after surgery. In comparison to group L, ≥50% pain relief was significantly better in group C. No serious complications were observed except for ≤20% of ecchymoma at the needle insertion site.This prospective study indicated that cervicogenic headaches may benefit from nucleoplasty.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jiaxiang Ni
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China
- Correspondence: Jiaxiang Ni, Department of Pain Management, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng, Beijing 100053, China (e-mail: )
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Kotlyar A, Brener R, Lis M. Use of Dr. Tan's Chinese Balance Acupuncture for Treatment of Chronic Neck–Shoulder Pain. Med Acupunct 2016. [DOI: 10.1089/acu.2015.1156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Arkady Kotlyar
- Outpatient Pain Clinic, Kaplan Medical Center, Rehovot, Israel
| | - Rina Brener
- Outpatient Pain Clinic, Kaplan Medical Center, Rehovot, Israel
| | - Michael Lis
- Outpatient Pain Clinic, Kaplan Medical Center, Rehovot, Israel
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