Combined Continuous Radiofrequency Ablation and Pulsed Neuromodulation to Treat Cervical Facet Joint Pain and Alleviate Postcervical Radiofrequency Side Effects

Abstract

Background: Continuous radiofrequency ablation (RFA) can effectively manage cervical facet joint pain related to neuropathic symptoms in the post-radiofrequency period. Additionally, pulse radiofrequency (PRF) provides relief of neuropathic symptoms. However, the effect of combined RFA and PRF has yet to be determined. Objectives: The study aimed to compare the effectiveness and safety of RFA (CRF group) and combined RFA and PRF (CPRF group). Methods: The study retrospectively reviewed the charts of patients with cervical facet joint pain undergoing RFA between June 1, 2014, and June 1, 2017, or combined RFA and PRF between June 1, 2017, and June 1, 2020, at a pain research center. Thirty-nine consecutive patients identified from charts meeting the inclusion criteria were included and classified in CRF (n = 22) and CPRF groups (n = 17). The results were evaluated using a Visual Analog Scale (VAS) and neck pain disability index (NDI) before procedures and 1, 3, and 6 months after the injections. Successful treatment was expressed as at least 80% pain relief from baseline and NDI score 0.05). The median time to the reoccurrence of at least 50% of preprocedural pain level was 303.8 days in the CRF group and 270 days in the CPRF group (P = 0.395). However, the CPRF group showed significantly less postoperative numbness, dysesthesia, and hypersensitivity syndrome than the CRF group (P < 0.05). Conclusions: Combined RFA and PRF can be complementary treatment for cervical facet joint pain, providing an adequate success rate and duration of pain relief as RFA alone but with significantly fewer post-radiofrequency side effects.

Effectiveness of Percutaneous Radiofrequency Cervical Zygapophyseal Neurotomy in Improving Chronic Cervicogenic Headache

“…Some patients did nevertheless report discomfort in their posterior neck for two to seven days after the treatments. Ataxia, numbness, itching, hypersensitivity, and paresthesias are examples of neropathic adverse reactions that have been reported before (15) . In fact, twenty-nine percent of cases treatment with a cervical medial branch neurotomy from C three to C seven have been reported to have numbness in the cutaneous distribution of a targeted nerve.…”

Non-pharmacological methods of treating chronic non-specific neck pain, possibilities of radiofrequency denervation: A review

“…В отличие от непрерывной РЧД импульсная более безопасна, так как при ней температура в окружающих нерв тканях не превышает 42°C, что предотвращает их необратимое повреждение. Однако продолжительность обезболивания после импульсной РЧД короче, чем при непрерывной [31,32].…”