Long-Term Effect of Pulsed Radiofrequency on Chronic Cervical Radicular Pain Refractory to Repeated Transforaminal Epidural Steroid Injections

Choi, Gyu-Sik; Ahn, Sungjin; Cho, Yun-Woo; Lee, Dong Gyu

doi:10.1111/j.1526-4637.2011.01313.x

Cited by 48 publications

(55 citation statements)

References 27 publications

(38 reference statements)

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“…Given the fact that epidural steroid injections usually provide short-term pain relief, we would speculate that the impressive outcomes of at least 3 months' pain relief and numbness reduction are primarily due to the therapeutic effects of PRF treatment in this study. This is consistent with a previous study that demonstrated that a long-term efficacy of PRF and a 71.5% satisfaction rate in patients with CCRP [5]. Further studies with randomized and placebo controlled trials are needed to investigate the therapeutic effects of each of these treatments.…”

Section: Discussionsupporting

confidence: 92%

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A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study

Xiao

et al. 2015

Journal of Clinical Anesthesia

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Section: Discussionsupporting

confidence: 92%

“…Selective cervical nerve root block (SCNRB) and pulsed radiofrequency (PRF) treatment have been used to manage CCRP [4][5][6]. Typically, each of these procedures is performed via an anterolateral approach under fluoroscopy guidance.…”

Section: Introductionmentioning

confidence: 99%

A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study

Xiao

et al. 2015

Journal of Clinical Anesthesia

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“…[22,23] Currently, PRF is used for various types of pain, including neuralgia, joint pain, and myofascial pain. [24–26] PRF stimulation on the lumbar medial branch has been reported to have a positive effect in the control of LFJ pain. [9,12] In addition, PRF stimulation after placement of the needle electrodes into a joint space can effectively reduce refractory joint pain.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intra-articular lumbar facet joint pulsed radiofrequency and intra-articular lumbar facet joint corticosteroid injection for management of lumbar facet joint pain

Hee

Ahn²,

Cho³

et al. 2017

Medicine

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Background:This study aimed to demonstrate the effect of intra-articular (IA) lumbar facet joint (LFJ) pulsed radiofrequency (PRF) for the management of LFJ pain, and to compare the effect of IA LFJ PRF to IA corticosteroid injection (ICI). Pathology in the LFJ is a common source of lower back pain (LBP). It is responsible for chronic LBP in approximately 15% to 45% of patients. It has been reported that PRF stimulation can effectively reduce refractory joint pain.Methods:Sixty patients with LFJ pain were recruited and randomly assigned to 1 of 2 groups: the IA PRF group and the ICI group. There were 30 patients in each group. At pretreatment, 2 weeks, 1, 3, and 6 months after treatment, we assessed the severity of LBP using a numeric rating scale (NRS).Results:Compared with the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 2 weeks, and 1, 3, and 6 months after each treatment. Between groups, changes in the NRS scores were significantly different over time. At 2 weeks and 1 month after each procedure, the NRS score after ICI was significantly lower than that after the PRF stimulation. However, at 3 and 6 months after the procedures, the decrements of NRS scores were not significantly different between the 2 groups. Six months after treatment, about half of patients in both groups reported successful pain relief (pain relief of ≥50%).Conclusion:In the current study, both IA PRF stimulation and ICI into the LFJ significantly relieved LFJ pain. Their effects persisted for at least 6 months after the procedure. Thus, IA PRF is a useful therapeutic option for the management of LFJ pain.

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“…Therefore, various techniques have been applied for the management of uncontrolled cervical radicular pain. [9–11] …”

Section: Introductionmentioning

confidence: 99%

“…[18–20] To date, several studies have reported that PRF stimulation of the dorsal root ganglion (DRG) can successfully manage cervical radicular pain. [6,9,21] However, in the clinical practice, despite undergoing PRF, some patients continue to complain of persisted cervical radicular pain. In all previous PRF studies, a single cannula was used to produce a therapeutic electrical field.…”

Section: Introductionmentioning

confidence: 99%

Effect of bipolar pulsed radiofrequency on refractory chronic cervical radicular pain

Lee

2017

Medicine

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Rationale:Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs.Patient concerns:Patients 1 and 2 presented with a numeric rating scale (NRS) score of 7 and 6 for chronic cervical radicular pain, respectively, despite undergoing monopolar PRF and 2 TFESIs.Diagnoses:On cervical magnetic resonance imaging, foraminal stenosis at the right C6–7 and right central to right foraminal disc protrusion on C6–7 were observed in patients 1 and 2, respectively. Two patients showed a positive response on diagnostic right C7 selective nerve root block with 0.5 mL of 1% lidocaine.Interventions:Bipolar PRF stimulation was performed under C-arm fluoroscopy. Two parallel RF cannulas (less than 1 cm apart) were used for DRG stimulation. The PRF treatment was administered at 5 Hz and a 5-ms pulsed width for 360 seconds at 45 V with the constraint that the electrode tip temperature did not exceed 42°C.Outcomes:At the 2-week and 1-month follow-up, after undergoing bipolar PRF, the pain of patient 1 was completely relieved, and at 2, 3, and 6 months, the pain was scored as NRS 2. In patient 2, at the 2-week follow-up after undergoing bipolar PRF, pain severity was reduced from NRS 6 to 2. The effect of bipolar PRF on patient 2 lasted for at least 6 months. No adverse effects were observed in either patient.Lessons:Application of bipolar PRF to DRGs seems to be an effective and safe technique for treating refractory chronic cervical radicular pain.

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Long-Term Effect of Pulsed Radiofrequency on Chronic Cervical Radicular Pain Refractory to Repeated Transforaminal Epidural Steroid Injections

Abstract: Application of PRF to the DRG appears to be an effective and relatively safe intervention technique for chronic cervical radicular pain refractory to repeated TFESIs.

Cited by 48 publications

References 27 publications

A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study

A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study

Comparison of intra-articular lumbar facet joint pulsed radiofrequency and intra-articular lumbar facet joint corticosteroid injection for management of lumbar facet joint pain

Effect of bipolar pulsed radiofrequency on refractory chronic cervical radicular pain

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