title: Clinical Efficacy of Selective Focal Ablation by Navigable Percutaneous Disc Decompression Device in Patients With Cervical Herniated Nucleus Pulposus.
abstract: OBJECTIVE
  To evaluate the clinical efficacy and safety following percutaneous disc decompression, using navigable disc decompression device for cervical herniated nucleus pulposus (HNP).
  
  
  METHODS
  Twenty subjects diagnosed with cervical HNP and refractory to conservative management were enrolled for the study. The herniated discs were decompressed under fluoroscopic guidance, using radiofrequency ablation device with navigable wand. The sagittal and axial plain magnetic resonance images of the clinically significant herniated disc, decided the space between the herniated base and outline as the target area for ablation. Clinical outcome was determined by Numeric Rating Scale (NRS), Neck Disability Index (NDI), and Bodily Pain scale of Short Form-36 (SF-36 BP), assessed after 48 weeks. After the procedure, we structurally matched the magnetic resonance imaging (MRI) and C-arm images through bony markers. The wand position was defined as being 'correct' if the tip was placed within the target area of both AP and lateral views; if not, the position was stated as 'incorrect'.
  
  
  RESULTS
  The average NRS fell from 7 to 1 at 48 weeks post procedure (p<0.05). In addition, statistically significant improvement was noted in the NDI and SF-36BP (p<0.05). The location of the wand tip resulted in 16 correct and 4 incorrect placements. Post-48 weeks, 3 of the incorrect tip cases and 1 correct tip case showed unsuccessful outcomes.
  
  
  CONCLUSIONS
  The study demonstrated the promising results and safety of the procedure. Thus, focal plasma ablation of cervical HNP with navigable wand can be another effective treatment option.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Sung Hoon
authors.identifier: 0000-0001-6691-708X
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Sang-Heon
authors.identifier: 0000-0003-0701-0028
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Nack Hwan
authors.identifier: 0000-0002-9650-2755
authors.initials: NH
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Min Hyun
authors.identifier: 0000-0001-6605-8705
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Hyeun Jun
authors.identifier: 0000-0002-3830-7994
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Yong Jin
authors.identifier: 0000-0002-5839-2268
authors.initials: YJ
authors.lastname: Jung
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Hyun-Joon
authors.identifier: 0000-0002-3610-1765
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Won Jun
authors.identifier: 0000-0002-8886-7105
authors.initials: WJ
authors.lastname: Meng
authors.affiliation: College of Arts and Sciences, University of Virginia, Charlottesville, VA, USA.
authors.forename: Victoria
authors.identifier: 0000-0002-0091-2988
authors.initials: V
authors.lastname: Kim
keywords: Catheter ablation; Cervical spine; Minimally invasive; Neck pain