Cervical intradiscal radiofrequency lesioning: A feasiblity study

Abstract

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. Design: 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. Setting: Fluoroscopy suite. Materials: Disarticulated cervical spine specimens. Interventions: Intradiscal RF lesioning in the middle and posterior portion of the cervical disc at 85°C for 10 minutes. Outcome Measures: 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. © 2008 by American Academy of Pain Medicine.