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Semin Musculoskelet Radiol 2011; 15(2): 172-180
DOI: 10.1055/s-0031-1275601
© Thieme Medical Publishers

Percutaneous Techniques for Cervical Pain of Discal Origin

Afshin Gangi1 , Georgia Tsoumakidou1 , Xavier Buy1 , Jose Facundo Cabral1 , Julien Garnon1
  • 1Department of Non-Vascular Interventional Radiology, University Hospital, University of Strasbourg, Strasbourg, France
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Publication History

Publication Date:
15 April 2011 (online)

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ABSTRACT

Cervical discogenic pain is an important cause of suffering and disability in the adult population. Pain management in cervical disc herniation relies initially on conservative care (rest, physiotherapy, and oral medications). Once conservative treatment has failed, different percutaneous minimally invasive radiological procedures can be applied to relief pain. This article offers a systematic review on the percutaneous minimally invasive techniques that can be advocated for the treatment of cervical pain of discal origin.

Periradicular steroid injection under image guidance (computed tomography or magnetic resonance imaging) is the first technique to be considered. The steroid injection aims at reducing the periradicular inflammation and thus relieves the radicular pain. The steroid injections present satisfying short-term results, but pain can recur in the long term.

Whenever the steroid injections fail to relieve pain from a contained cervical disc herniation, the more invasive percutaneous disc decompression techniques should be proposed. Percutaneous radiofrequency nucleoplasty is the most often applied technique on the cervical level with a low risk of thermal damage. When the indications and instructions are respected, radiofrequency nucleoplasty presents accepted safety and efficacy levels.

KEYWORDS

Cervical - minimally invasive - disc - CT guidance - radiofrequency nucleoplasty - infiltrations

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Afshin GangiM.D. Ph.D. 

1 Pl. de l'Hôpital

67000 Strasbourg, France

Email: gangi@rad6.u-strasbg.fr