1. 2020;23;E265-E272Effectiveness of Ultrasound-Guided Pulsed Radiofrequency Treatment in Patients with Refractory Chronic Cervical Radicular Pain
   Prospective Study
   Min Cheol Chang, MD, Eugene Yousik Roh, MD, Hyun Hee Choi, ., and Sang Hoon Lee, MD.

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 post-PRF (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