Evaluation of the efficacy of ultrasound-guided selective cervical nerve root pulsed radiofrequency treatment in patients with chronic cervical radicular pain

• Published in: Journal of ultrasound Vol. 27; no. 4; pp. 847 - 855
• Main Authors: Can, Ezgi, Akkaya, Ömer Taylan
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2024; Springer Nature B.V
• Subjects: Adult; Aged; Cervical Vertebrae - diagnostic imaging; Chronic Pain - diagnostic imaging; Chronic Pain - therapy; Effectiveness; Female; Humans; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral Disc Displacement - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Neck Pain - therapy; Nerves; Neuralgia - therapy; Original Paper; Pain; Pain Measurement; Pretreatment; Pulsed Radiofrequency Treatment - methods; Radiation effects; Radiculopathy - diagnostic imaging; Radiculopathy - therapy; Radio frequency; Real time; Spinal Nerve Roots - diagnostic imaging; Treatment Outcome; Ultrasonic imaging; Ultrasonography, Interventional - methods; Ultrasound; United States > US; Disc herniation; Analgesia; Cervical radicular pain; Pulsed radiofrequency; Ultrasonography
• ISSN: 1876-7931; 1971-3495; 1876-7931
• DOI: 10.1007/s40477-024-00950-4

Purpose
Management of cervical radicular pain is complex and may be resistant to conservative treatment. The primary aim of this study was to evaluate the efficacy of ultrasound-guided selective cervical nerve root pulsed radiofrequency (US-SCNR PRF) treatment in patients with radicular neck pain due to cervical disc herniation who did not respond to conservative treatment. The secondary aim was to determine the efficacy of the treatment in terms of functionality, neuropathic pain, and treatment-related adverse events.
Methods
This study included 62 patients with chronic cervical radicular pain who underwent US-SCNR PRF treatment. Pain intensity was assessed using the Numerical Rating Scale before treatment and at 1, 3, and 6 months after treatment. The Neck Disability Index and Douleur Neuropathique 4 Questions were used to assess functionality and neuropathic pain before and 6 months after treatment. Significant pain relief was defined as ≥ 50% reduction in the pain score compared with the pre-treatment score.
Results
Cervical radicular pain was significantly reduced at 1, 3, and 6 months after pulsed radiofrequency compared to pre-treatment (
P
 < 0.001). Successful pain relief was achieved in 59.6% of the patients at 6 month. However, there was no significant difference between the mean pain scores in the 1st month, 3rd month and 6th month. In addition, the functionality and neuropathic pain scores were significantly reduced at 6 month.
Conclusions
These results suggest that US-SCNR PRF treatment is effective for cervical radicular pain, functionality, and neuropathic pain for at least six months in the majority of patients with refractory cervical radicular pain, and is considered a safer and preferable treatment modality due to real-time visualization of the cervical nerve roots and adjacent neurovascular structures and no radiation exposure.