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Pain Pract. 2017 Jun;17(5):589-595. doi: 10.1111/papr.12493. Epub 2016 Oct 14.

A Randomized Comparative Study of Pulsed Radiofrequency Treatment With or Without Selective Nerve Root Block for Chronic Cervical Radicular Pain.

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Department of Anesthesiology & Pain Medicine, Guangdong Medical College, HuiZhou First Hospital, Jiangbei, Huizhou, Guangdong, China.
Department of Pain Management, Guangdong Medical College, Shenzhen Nanshan Hospital, Nanshan, Shenzhen, China.
Department of Pain Management, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.



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.


cervical nerve root block; chronic cervical radicular pain; numeric rating scale; posterior approach; pulsed radiofrequency

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