Effect of intradiscal pulsed radiofrequency on refractory chronic discogenic neck pain: A case report

RATIONALE: Despite medication, exercise, and medical intervention, many patients complain of persistent discogenic neck pain. To manage discogenic neck pain, we performed intradiscal pulsed radiofrequency (PRF) stimulation in a patient with chronic discogenic neck pain refractory to oral medication and epidural steroid injection. PATIENT CONCERNS: A 26-year-old man presented with a numeric rating scale (NRS) score of 7 for chronic neck pain. His pain was worse when the neck was held in one position for a prolonged period. There was no pain in the upper extremities. DIAGNOSES: Discography was positive at C4–5. Based on the pain characteristics, and the result of discography, we diagnosed him as having discogenic neck pain originating from C4–5. INTERVENTIONS: Intradiscal PRF on the C4–5 intervertebral disc was performed under C-arm fluoroscopy. The PRF treatment was administered at 2 Hz and a 20-ms pulsed width for 20 minutes at 60 V with the constraint that the electrode tip temperature should not exceed 42°C. OUTCOMES: At the 2-week, and 1-month follow-up visits, the patient's pain was completely relieved. At 2, and 3 months after intradiscal PRF, the pain was scored as NRS 2. No adverse effects of intradiscal PRF stimulation were observed. LESSONS: Application of intradiscal PRF appears to be an effective and safe technique for treating chronic discogenic neck pain.