Treatment of Cervicobrachialgia Utilizing Percutaneous Cervical Disc Nucleoplasty: One Year Follow-Up

Objective Patients suffering from cervicobrachialgia had only the therapeutical solution between conservative treatment and monosegmental spondylodesis or disc prosthesis of the mentioned motion segment. We want to evaluate the effect of a clinically demonstrated innovation ”percutaneous cervical disc nucleoplasty” in percutaneous disc decompression. Methods From October 2008 to October 2009, 29 patients with magnetic resonance imaging (MRI) proven contained herniated cervical disc were treated by nucleoplasty with the Perc- DC® Spine Wand (Arthrocare®) on the pathological disc after conservative treatment about on average 3 months. A control group of 29 patients was enrolled within the same criteria with only conservative treatment. With a follow-up time of 1-years we evaluated an average pain reduction by the visual pain score (VAS). The VAS was checked 24 h, 1 week, 3, 6, 12 months after treatment. Results There were 18 female and 11 male persons with a mean age of 23 49 years. The mean VAS was 8.8 just before surgical treatment and 2.3 after 1 year follow-up. The mean age of the persons was 26-56 years. The VAS was 8.4 on average just before starting conservative treatment. The distribution of the prolapse to the motion segment of the cervical spine was conservative/surgical group: C4/5 (8 respectively 7 patients), C5/6 (19 respectively 17 patients) and C6/7 (2 respectively 6 patients.) The total number of 29 nucleoplasty were performed (three on two adjacent levels). The C4/5 disc level was treated in eight cases (28%), C5/6 in 19 cases (65%) and C6/7 in two cases (7%) with the Perc-DC® Spine Wand. All patients were immediately mobilized. No complications with this method were seen. Conclusion Percutaneous cervical disc nucleoplasty is a fast and secure treatment for cervicobrachialgia. Furthermore, a diminution of pain after the cervical nucleoplasty which has the optimal results without taking medication after 1 to 3 months was found.