Efficacy of Coblation Technology in Treating Cervical Discogenic Upper Back Pain

Abstract

Upper back pain originating from the cervical disk itself is defined as cervical discogenic upper back pain. Coblation procedures can provide therapeutic effects for neck and radicular pain related to contained cervical disk herniation. However, no studies have reported the performance of coblation procedures, particularly for treating cervical discogenic upper back pain. The purpose of this study was to evaluate the efficacy of coblation procedures in treating cervical discogenic upper back pain. In a prospective, clinical, observational study, 28 consecutive patients with discogenic upper back pain underwent coblation procedures on the cervical disk with a percutaneous anterior approach. Pain visual analogue scale (VAS) scores, patient responses stating significant (>50%) pain relief, significant (>50%) reduction in pain medicine intake and Modified MacNab criteria were adopted to evaluate the pain intensity, degree of pain relief, and functional status after 12 months of follow-up. The preoperative pain VAS score was 6.5±1.1 (95% confidence interval [CI] 6.085-6.915), and the pain VAS score significantly decreased to 2.4±1.3 (95% CI 1.929-2.928), 2.5±1.5 (95% CI 1.963-3.109), 2.7±1.4 (95% CI 2.157-3.271), 3.1±1.6 (95% CI 2.457-3.686), and 3.1±1.6 (95% CI 2.471-3.743) at 1 week and 1, 3, 6, and 12months postoperatively, respectively (P<0.05). Twenty-two (78.6%), 21 (75.0%), 20 (71.4%), 19 (67.9%), and 18 (64.3%) of the patients expressed significant pain relief at 1 week and 1, 3, 6, and 12 months postoperatively, respectively. 24 (85.7%), 23 (82.1%), 23 (82.1%), and 22 (78.6%) reported significant reduction in pain medication intake at 1, 3, 6, and 12 months postoperatively, respectively. According to the ModifiedMacNab criteria, the numbers of patients with ''excellent'' or ''good'' ratings were 22 (78.6%), 21 (75.0%), 20 (71.4%), and 18 (64.3%) at 1, 3, 6, and 12 months postoperatively, respectively. No serious complications were observed. The findings of this study showed that coblation is an effective, safe, minimally invasive, and less uncomfortable procedure for the treatment of discogenic upper back pain.