Retrospective Outcome Evaluation of Cervical Nucleoplasty Using Digital Infrared Thermographic Imaging

Kim, Do Hyung; Kim, Young Soo; Shin, Sang Joon; Kang, Hyun; Kim, Seokhoon; Shin, Hwa Yong

Abstract

OBJECTIVE
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. Herein, 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 difference (Î”TD) with the changes in pain intensity after PCN expressed as visual analogue scale (Î”VAS) scores.
METHODS
For this study, 255 patients treated with PCN at Thomas Hospital between March 2012 and August 2014 were included. For each patient, demographic and clinical data, including preoperative MRI results, Î”VAS, Î”TD at the disc level treated with PCN, subjective symptom improvement, procedure-related discomfort, overall satisfaction, and adverse effects, were collected and evaluated for up to 3 months retrospectively.
RESULTS
Thermal difference (TD) and VAS scores improved after PCN (p<0.05), but Î”TD showed no significant correlation with Î”VAS. If the preoperative TD was larger, the postoperative VAS was worse and there was less pain relief (Î”VAS) after PCN (p<0.05). Only few adverse effects were noticeable after PCN.
CONCLUSION
In DITI, which was used to evaluate the outcomes after cervical nucleoplasty, the Î”TD did not seem to reflect the Î”VAS after PCN. However, preoperative DITI findings could be useful for predicting VAS reduction and clinical improvements after PCN.