title: A Randomized Comparative Study of Pulsed Radiofrequency Treatment With or Without Selective Nerve Root Block for Chronic Cervical Radicular Pain.
abstract: We demonstrated a combination of pulsed radiofrequency (PRF) and cervical nerve root block (CNRB) via a posterior approach was superior to a transforaminal epidural steroid injection through the anterolateral approach for cervical radicular pain in a previous study. This randomized trial was conducted to determine the comparative efficacy between CNRB, PRF, and CNRB + PRF for cervical radicular pain.
  
  
  
  A prospective and randomized design was used in this study. Sixty-two patients were randomized into three parallel groups: CNRB, PRF, or CNRB + PRF. Numeric Rating Scale (NRS) was used to measure pain intensity, and global perceived effect (GPE) was scored by the patient on a 7-point scale, ranging from much worse (-3), no change (0), to total improvement (+3). The outcomes were evaluated at 1 week, 1 month, 3 months, and 6 months. Side effects and complications were noted.
  
  
  
  The NRS was significantly reduced in all three groups 1 week after the treatments (P < 0.001), and the rates of positive GPE (+2 or +3) were not significantly different between the three groups. At 1, 3, and 6 months of follow-ups, the combined therapy achieved significantly lower NRS and higher GPE compared to CNRB or PRF alone group (P < 0.001). There were no significant differences between the CNRB and PRF groups (P > 0.05). No serious complications were observed in any of the patients.
  
  
  
  Combining CNRB and PRF appeared to be a safe and efficacious technique for cervical radicular pain. The combination therapy yielded better outcomes than either CNRB or PRF alone.
authors.affiliation: Department of Anesthesiology & Pain Medicine, Guangdong Medical College, HuiZhou First Hospital, Jiangbei, Huizhou, Guangdong, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
authors.forename: Lizu
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
authors.forename: Donglin
authors.initials: D
authors.lastname: Xong
authors.affiliation: Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
authors.forename: Disen
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Pain Management, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: LiPing
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Pain Management, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Sigdha
authors.initials: S
authors.lastname: Ancha
authors.affiliation: Department of Pain Management, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Cheng
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D061208:Pulsed Radiofrequency Treatment / Q000379:methods*; D011843:Radiculopathy / Q000628:therapy*; D013126:Spinal Nerve Roots; D016896:Treatment Outcome
keywords: cervical nerve root block; chronic cervical radicular pain; numeric rating scale; posterior approach; pulsed radiofrequency