Four-year pain relief after coblation combined with active exercise for cervical discogenic pain

Abstract

Rationale: Coblation of intervertebral disc is an effective and safe minimally invasive technology for treating discogenic pain. The inactivation of neural ingrowth around annulus and tissue ablation and coagulation are currently considered to be the major causes for success of this treatment. However, it has been found by clinical researchers that its long-term clinical outcome is not optimistic. This report has given us favorable information that this situation can be improved with multimodal therapy. Patient concerns: A 61-year-old man presented with right severe neck and shoulder pain in 2014 which could not be relieved by medications. Diagnoses: According to his symptoms and signs, this patient was diagnosed with cervical discogenic pain. And discography confirmed the diagnosis. Interventions: The patient underwent coblation of cervical intervertebral disc 4–5 (C4–5) and got apparently pain relief after surgery. After 1 month, he began to perform active exercise at least 30 min every day. Outcomes: The right neck and shoulder pain completely relieved for 4 years. The cervical lordosis of this patient was restored in 2018 which was confirmed by MRI compared in 2014 and NDI (neck disability index) decreased from 58 to 10%. Lessons: This report demonstrated that it was important and essential for clinicians to educate patients with discogenic pain to perform active exercise after minimally invasive surgery.