Effectiveness of pulsed radiofrequency on the medial cervical branches for cervical facet joint pain

World J Clin Cases. 2022 Aug 6;10(22):7720-7727. doi: 10.12998/wjcc.v10.i22.7720.

Abstract

Background: Cervical facet joint pain (CFP) is one of the most common causes of neck pain and headache. Persistent CFP deteriorates the quality of life of patients and reduces their productivity at work.

Aim: To investigate the effectiveness of pulsed radiofrequency (PRF) stimulation of cervical medial branches in patients with chronic CFP.

Methods: We retrospectively included 21 consecutive patients (age = 50.9 ± 15.3 years, range 26-79 years; male: female = 8:13; pain duration = 7.7 ± 5.0 mo) with chronic CFP, defined as ≥ 4 on the numeric rating scale (NRS). We performed PRF stimulation on the cervical medial branches. The outcomes of the PRF procedure were evaluated by comparing the NRS scores for CFP before treatment and 1 and 3 mo after treatment. Successful pain relief was defined as a ≥ 50% reduction in the NRS score at 3 mo when compared with the pretreatment NRS score.

Results: No patient had immediate or late adverse effects following PRF. The average NRS score for CFP decreased from 5.3 ± 1.1 at pre-treatment to 2.4 ± 0.6 at the 1 mo follow-up, and 3.1 ± 1.1 at the 3 mo follow-up. Compared to the NRS scores before PRF stimulation, those at 1 and 3 mo after PRF stimulation had significantly decreased. Eleven of the 21 patients (52.4%) reported successful pain relief 3 mo after the PRF procedure. PRF stimulation on cervical medial branches may be a useful therapeutic option to control chronic CFP.

Conclusion: PRF stimulation of the cervical medial branches may be used as an alternative treatment method in patients with CFP. PRF can effectively alleviate CFP, and is safe to perform.

Keywords: Chronic pain; Neck pain; Pain; Pain management; Pulsed radiofrequency treatment; Zygapophyseal joint.