Effectiveness of Ultrasound-Guided Pulsed Radiofrequency Treatment in Patients with Refractory Chronic Cervical Radicular Pain

Abstract

Background: The effect of pulsed radiofrequency (PRF) stimulation for alleviating cervical radicular pain has been demonstrated in several previous studies. Objectives: We aimed to evaluate the effectiveness of PRF with ultrasound (US) guidance in patients with chronic cervical radicular pain that was refractory to repeated transforaminal epidural steroid injections (TFESIs). Study Design: A prospective outcome study. Setting: The outpatient clinic of a single academic medical center. Methods: This study included 49 patients with chronic cervical radicular pain, unresponsive to repeated TFESIs, and who underwent PRF stimulation under US guidance. Using US, a cannula was inserted toward the cervical spinal nerve. The pain intensity was evaluated using the Numeric Rating Scale (NRS-11) for cervical radicular pain at pretreatment and 1, 3, and 6 months posttreatment; and the Neck Disability Index (NDI) was used for evaluating functional disability before treatment and 6 months posttreatment. Successful pain relief was defined as ≥ 50% reduction in the NRS-11 score as compared with the score before treatment. Results: Cervical radicular pain was significantly reduced at 1, 3, and 6 months postPRF (P < 0.001). At 6 months post-PRF, functional disability (NDI score) had significantly reduced, and 63.3% of the patients achieved successful pain relief. Limitations: The small number of included patients and no long-term follow-up. Conclusions: PRF stimulation under the guidance of US is a potentially effective treatment method for managing refractory chronic cervical radicular pain. Key words: Ultrasound, pulsed radiofrequency, cervical radicular pain, chronic pain