Computed tomography-guided radiofrequency ablation of cervical intervertebral discs for the treatment of refractory cervicogenic headache: A retrospective chart review.

OBJECTIVE: To evaluate the feasibility and efficacy of computed tomography (CT)-guided radiofrequency ablation (RFA) of cervical intervertebral discs for the treatment of discogenic cervicogenic headache (CEH). BACKGROUND: Some patients with CEH experience no obvious therapeutic effect after conventional therapy, particularly patients with refractory CEH originating from abnormal cervical intervertebral discs. Treatment for this type of CEH remains poorly characterized. METHODS: Using a single intervention arm, pretest/posttest design, we retrospectively analyzed the data of patients who underwent CT-guided RFA of cervical intervertebral discs for CEH at the Pain Medicine Center of Zhejiang Provincial People's Hospital from January 2017 to April 2021. If conservative treatment failed in patients with discogenic CEH, we classified the patients as having refractory CEH and performed RFA of cervical intervertebral discs. We used a numeric rating scale (NRS) to assess pain intensity for 6 months. We also compared therapeutic outcome of patients with different characteristics. RESULTS: A total of 44 patients who underwent CT-guided RFA of cervical intervertebral discs were enrolled and 41 of them were analyzed in the present study. The preoperative median (25th, 75th) NRS score was 4 (4, 5), and it was significantly reduced to 1 (0, 4) 6 months after RFA (p < 0.001). The number of patients with ≥50% of their pain relieved after 6 months was 28 of 41 (68%). No serious treatment-related complications occurred in this study. Compared with single-level RFA, multi-level RFA shows greater effects on pain intensity reduction (p = 0.032) and pain relief rate (p = 0.047) of patients. CONCLUSION: In patients who have discogenic CEH, CT-guided RFA of the cervical intervertebral discs appears to be a promising treatment with no serious complications.

Vaspin prevents leptin­induced inflammation and catabolism by inhibiting the activation of nuclear factor­κB in rat chondrocytes.

The present study aimed to investigate the function and possible underlying mechanism of various concentrations of visceral adipose tissue­derived serine protease inhibitor (vaspin) on leptin­induced inflammatory and metabolic responses in rat chondrocytes. Rat articular chondrocytes were isolated and treated with different concentrations of vaspin, which was followed by stimulation with leptin. The expression of genes, secretion of nitric oxide and tumor necrosis factor­α, and activation of the nuclear factor (NF)­κB pathway were analyzed by reverse transcription­quantitative polymerase chain reaction, ELISA and western blotting. The results demonstrated that vaspin inhibited the leptin­induced upregulated gene expression levels of leptin receptor (OB­Rb), a disintegrin and metalloprotease with thrombospondin motifs (ADAMTS)­4, ADAMTS­5, matrix metalloproteinase (MMP)­2 and MMP­9, and the secretion of NO and TNF­α, in a dose­dependent manner. The phosphorylation of inhibitor of NF­κB (IκB), IκB kinase (IKK)α, IKKß and NF­κB were also promoted by leptin in the chondrocytes, which were also suppressed by increased concentration of vaspin. Taken together, results demonstrated that vaspin prevented leptin­induced inflammation and catabolism by inhibiting the activation of NF­κB in rat chondrocytes.