Curative effect and mechanism of radiofrequency ablation nucleoplasty in the treatment of cervical vertigo

Abstract

Objective: This study aims to investigate the curative effects and mechanism of radiofrequency ablation nucleoplasty in the treatment of cervical vertigo.

Methods: A total of 27 patients diagnosed with cervical vertigo from January 2012 to October 2014 received treatment of radiofrequency ablation nucleoplasty. The narrow-side vertebral artery diameters were examined by using Philips 1.5-T body dual-gradient MRI system. The haemodynamic parameters were detected by using transcranial Doppler sonography. Both of the vertebral artery diameters and haemodynamic parameters were recorded and compared before and after treatment. The curative effects in early post-operative application were evaluated according to the Nagashima standards.

Results: Radiofrequency ablation nucleoplasty was performed in a total of 59 cervical discs in 27 patients. The average operation time was 42.7 min, and the symptoms of 92.6% patients were alleviated after radiofrequency ablation nucleoplasty post-operation application. There was no significant difference in the narrow-side vertebral artery diameters before and after treatment in both Group A (p = 0.12) and Group B (p = 0.48); however, the blood flow velocity was significantly higher than that before treatment in both Group A (p = 0.01) and Group B (p = 0.03), respectively.

Conclusion: Radiofrequency ablation nucleoplasty improves the blood flow in the narrow-side vertebral artery and illustrates the therapeutic effect on cervical vertigo in patients who have no direct compression of the vertebral artery. Advances in knowledge: Radiofrequency intradiscal nucleoplasty can be used as a minimally invasive procedure for treating cervical vertigo.

Figure 1.

The distortion of left vertebral artery stenosis in MRA. The white arrow illustrates the distortion.

Figure 2.

The MRA twisted right vertebral artery stenosis. The white arrow illustrates the twisting.

Figure 3.

Intraoperative anteroposterior fluoroscopy. In the intraoperative anteroposterior fluoroscopy, in addition to obtaining an accurate reduction, combining the osteological details with the corresponding intraoperative fluoroscopic imaging is necessary to safely perform percutaneous fixation. The inlet and outlet fluoroscopic views are utilized to safely place iliosacral screws. An intraoperative lateral fluoroscopic view can be extremely helpful by providing a third dimension that helps verify the osteology seen in the inlet and outlet views.

Figure 4.

Intraoperative lateral fluoroscopy. In the intraoperative lateral fluoroscopy, in addition to obtaining an accurate reduction, combining the osteological details with the corresponding intraoperative fluoroscopic imaging is necessary to safely perform percutaneous fixation. The inlet and outlet fluoroscopic views are utilized to safely place iliosacral screws. An intraoperative lateral fluoroscopic view can be extremely helpful by providing a third dimension that helps verify the osteology seen in the inlet and outlet views.