A Randomized Comparative Study of Pulsed Radiofrequency Treatment With or Without Selective Nerve Root Block for Chronic Cervical Radicular Pain

• Published in: Pain practice Vol. 17; no. 5; pp. 589 - 595
• Main Authors: Wang, Fei, Zhou, Qian, Xiao, Lizu, Yang, Juan, Xong, Donglin, Li, Disen, Liu, LiPing, Ancha, Sigdha, Cheng, Jianguo
• Format: Journal Article
• Language: English
• Published: United States 01.06.2017
• Subjects: Adult; cervical nerve root block; chronic cervical radicular pain; Chronic Pain - therapy; Combined Modality Therapy - methods; Female; Humans; Male; Middle Aged; Neck Pain - therapy; Nerve Block - methods; numeric rating scale; posterior approach; Prospective Studies; pulsed radiofrequency; Pulsed Radiofrequency Treatment - methods; Radiculopathy - therapy; Spinal Nerve Roots; Treatment Outcome; cervical nerve root block; pulsed radiofrequency; numeric rating scale; posterior approach; chronic cervical radicular pain
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12493

Background We demonstrated a combination of pulsed radiofrequency (PRF) and cervical nerve root block (CNRB) via a posterior approach was superior to a transforaminal epidural steroid injection through the anterolateral approach for cervical radicular pain in a previous study. This randomized trial was conducted to determine the comparative efficacy between CNRB, PRF, and CNRB + PRF for cervical radicular pain. Methods A prospective and randomized design was used in this study. Sixty‐two patients were randomized into three parallel groups: CNRB, PRF, or CNRB + PRF. Numeric Rating Scale (NRS) was used to measure pain intensity, and global perceived effect (GPE) was scored by the patient on a 7‐point scale, ranging from much worse (−3), no change (0), to total improvement (+3). The outcomes were evaluated at 1 week, 1 month, 3 months, and 6 months. Side effects and complications were noted. Results The NRS was significantly reduced in all three groups 1 week after the treatments (P < 0.001), and the rates of positive GPE (+2 or +3) were not significantly different between the three groups. At 1, 3, and 6 months of follow‐ups, the combined therapy achieved significantly lower NRS and higher GPE compared to CNRB or PRF alone group (P < 0.001). There were no significant differences between the CNRB and PRF groups (P > 0.05). No serious complications were observed in any of the patients. Conclusions Combining CNRB and PRF appeared to be a safe and efficacious technique for cervical radicular pain. The combination therapy yielded better outcomes than either CNRB or PRF alone.