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DOI: https://doi.org/10.14245/ns.1836124.062    [Accepted]
Published online October 7, 2018.
Retrospective Outcome Evaluation of Cervical Nucleoplasty Using Digital Infrared Thermographic Imaging
Do Hyung Kim1, Young Soo Kim1, Sang Joon Shin1, Hyun Kang2, Seokhoon Kim2  , Hwa Yong Shin2 
1Kim Young Soo Spine Hospital, Seoul, Korea
2Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
Corresponding Author:  Hwa Yong Shin
Tel: +82-2-6299-3164    Fax: +82-2-6299-2585    Email: pain@cau.ac.kr
Received: May 13, 2018   Revised: July 16, 2018   Accepted: August 21, 2018
Abstract
Purpose
Percutaneous cervical nucleoplasty (PCN) is used to treat cervical disc herniation. Radiological imaging studies, including, plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI), have been used to make early predictions of cervical spinal surgery outcomes. However, simple radiological studies do not provide sufficiently detailed information; moreover, CT and MRI are highly expensive. Here we aimed to elucidate the usefulness of digital infrared thermography imaging (DITI) as an outcome marker after cervical nucleoplasty by correlating the changes in thermal differences (ΔTD) with the changes in pain intensity after PCN expressed as visual analogue scale (ΔVAS) scores.
Materials and Methods
For this study, 255 patients treated with PCN in *** Spine Hospital between March 2012 and August 2014 were included. In each patient, demographic data, including preoperative MRI results, ΔVAS, and ΔTD at the corresponding disc level treated with PCN, subjective symptom improvement, procedure-related discomfort, overall satisfaction, and adverse effects, were collected and evaluated up to 3 months retrospectively.
Results
TD and VAS scores were improved after PCN (P < 0.05), but ΔTD had no significant correlation with ΔVAS. If the preoperative TD was larger, the postoperative VAS was worse and the pain relief (ΔVAS) after PCN was smaller (P < 0.05). Only few adverse effects were noticeable after PCN.
Conclusion
DITI, which was used to evaluate the outcomes after cervical nucleoplasty showed that the ΔTD does not seem to reflect the ΔVAS after PCN. However, preoperative DITI findings could be useful for predicting the VAS reduction and clinical improvement after PCN.
Keywords: Ablation Technique; Cervical Vertebrae; Neck Pain; Intervertebral Disc; Thermography


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