Retrospective Outcome Evaluation of Cervical Nucleoplasty Using Digital Infrared Thermographic Imaging

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 (ΔTD) with the changes in pain intensity after PCN expressed as visual analogue scale (ΔVAS) 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, ΔVAS, ΔTD 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 ΔTD showed no significant correlation with ΔVAS. If the preoperative TD was larger, the postoperative VAS was worse and there was less pain relief (ΔVAS) 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 ΔTD did not seem to reflect the ΔVAS after PCN. However, preoperative DITI findings could be useful for predicting VAS reduction and clinical improvements after PCN.