Journal
PAIN
Volume 127, Issue 1-2, Pages 173-182Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.pain.2006.09.002
Keywords
pulsed radiofrequency; cervical radicular pain; global perceived effect; visual analogue scale; Spurling test; dorsal root ganglio; randomized clinical trial
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Cervical radicular pain affects approximately I on 1000 adults per year. Although many treatment modalities are described in the literature, the available evidence for efficacy is not sufficient to allow definitive conclusions on the optimal therapy to be made. The effect of pulsed radiofrequency treatment for this type of patients was evaluated in a prospective audit that showed satisfactory pain relief for a mean period of 9.2 months, justifying a randomized sham controlled trial. Twenty-three patients, out of 256 screened, met the inclusion criteria and were randomly assigned in a double blind fashion to receive either pulsed radiofrequency or sham intervention. The evaluation was done by an independent observer. At 3 months the pulsed radiofrequency group showed a significantly better outcome with regard to the global perceived effect (> 50%, improvement) and visual analogue scale (20 point pain reduction). The quality of life scales also showed a positive trend in favor of the pulsed radiofrequency group, but significance was only reached in the SF-36 domain vitality at 3 months. The need for pain medication was significantly reduced in the pulsed radioftequency group after six months. No complications were observed during the study period. These study results are in agreement with the findings of our previous clinical audit that pulsed radiotrequency treatment of the cervical dorsal root ganglion may provide pain relief for a limited number of carefully selected patients with chronic cervical radicular pain as assessed by clinical and neurological examination. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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