Cervical intradiscal radiofrequency lesioning: a feasiblity study.
OBJECTIVE
The objective of this benchtop study was to establish if single site, long duration intradiscal radiofrequency (RF) at two different positions could generate adequate heating throughout the intervertebral disc to potentially ablate intradiscal nociceptors.


METHODS
The disarticulated cervical spines from four fresh frozen cadavers were studied. Temperature recording was completed from two different positions of the RF needle. The needle was either placed in the middle of the disc in four discs, or it was inserted in the posterior quarter of the disc, in eight discs. Thermocouple measurements were made every 2 minutes from three positions: middle of the disc, posterolateral aspect of the disc, and in the anterior third of the disc.


METHODS
Fluoroscopy suite.


METHODS
Disarticulated cervical spine specimens.


METHODS
Intradiscal RF lesioning in the middle and posterior portion of the cervical disc at 85 degrees C for 10 minutes.


METHODS
Local temperature within the disc.


RESULTS
Lesioning in either the middle or posterior portion of the disc failed to provide sufficient temperature increases throughout the cervical disc to achieve adequate denervation.


CONCLUSIONS
As in the lumbar spine, intradiscal cervical RF provides too focal a thermal profile to effectively denervate the disc even in an ex vivo experiment. Thus, single site, long duration cervical intradiscal RF lesioning in vivo cannot be recommended.
Dreyfuss
Paul
P
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA. pauldreyfuss@gmail.com
Marquardt
Carolyn
C
Tencer
Allen
A
Alexander
Eric
E
D002102:Cadaver; D017115:Catheter Ablation; D002574:Cervical Vertebrae; D005240:Feasibility Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007403:Intervertebral Disc; D019547:Neck Pain / Q000473:pathology / Q000601:surgery; D011846:Radio Waves; D013696:Temperature