Ultrasound-guided high-voltage pulsed radiofrequency versus standard-voltage pulsed radiofrequency in refractory chronic cervical radicular pain randomized clinical trial

Abstract

Purpose: To appraise the therapeutic impact of high-voltage pulsed radiofrequency (HVPRF) on the management of refractory unilateral cervical radicular pain. Methods: The study was conducted on 100 patients who had refractory chronic unilateral cervical radicular pain. Patients were divided into two equal groups (50 patients each): group (S): standard-voltage pulsed radiofrequency (SVPRF); and group (H): HVPRF. All patients received ultrasound-guided PRF on the affected cervical nerve root, either SVPRF in group (S) or HVPRF in group (H). The primary outcome was to assess the number of patients who experienced successful pain relief at 6 months’ post-intervention, which is defined as ≥ 50% reduction of visual analog scale (VAS) from pre-intervention level. Secondary outcome was to assess the impact of treatment on neck disability index (NDI) which was evaluated before treatment, 1, 3, and 6 months after the procedure. Results: VAS and NDI values were significantly reduced in group (H) in comparison to group (S) at all follow-ups. After 6 months, all patients in group (H) showed a clinically meaningful response with ≥ 50% decrease in VAS score. Conversely, no participants in group (S) attained a comparable decrease in their VAS scores. Conclusion: HVPRF could significantly reduce pain and functional disabilities compared to SVPRF up to 6 months after intervention in patients suffering from unilateral resistant cervical radiculopathy. IRB number: Fayoum Faculty of Medicine Research Ethical Committee, approval no. R 427. Research registration number: Registry for Clinical Trials (NCT05749185).