Cadaveric intervertebral disc temperature mapping during disc biacuplasty.

BACKGROUND: Disc Biacuplasty is a procedure for treating discogenic pain through neuron ablation by heating intervertebral disc tissue using cooled, bipolar radiofrequency (RF) technology. This study demonstrates temperature profiles created by disc biacuplasty in human cadavers.

OBJECTIVE: To assess temperature profiles created by disc biacuplasty in human cadaver discs.

DESIGN: The design of the experiment is a cadaver study with temperature monitoring in the intervertebral disc during disc biacuplasty.

METHOD: Seven human cadaver discs were sectioned from 2 cadavers. Each disc was instrumented with 11 [corrected] temperature sensors and 2 cooled radiofrequency probes. Correct placement was verified with the aid of fluoroscopy. The discs were then immersed in a 37 degrees C thermostatic water bath and the treatment protocol was applied. Temperatures were monitored as the discs were heated.

RESULTS: At 13 minutes, with the settings used in this study, the posterior longitudinal ligament (PLL) temperature reached 40+/-3 degrees C. The anterior disc reached 41+/-3 degrees C. The outer layer of the posterior annulus fibrosus was heated to 54+/-6 degrees C and the inner two-thirds of the posterior annulus fibrosus reached temperatures of 60+/-6 degrees C.

CONCLUSIONS: The anterior disc and PLL remained at safe temperatures below 45 degrees C while temperatures throughout the center posterior and posterolateral disc were all raised above 45 degrees C, sufficient for neural ablation.