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Pulsed vs Continuous Radiofrequency Neurotomy for Cervical Facet Joint Mediated Pain

Shoulder Pain Chronic | Faceto-genic Neck Pain | Faceto-genic Headache

Different studies have revealed different success rates and patient satisfaction after cervical facet C-RF. In a study on 32 patients, with 15 months follow up, 25% had complete pain relief (8). Another study had shown mean pain relief of 12.5 months and 11.5 months following a repeat procedure, with an effectiveness of 95% in 47 patients (8). In one study a success rate of 88% after first RF, and 86% following a repeat RF in 49 patients with facet mediated cervicogenic headache. They regarded the absence of anesthesia in the distribution of the 3rd occipital nerve, a technical failure (9). In a study from New Zealand, demonstrated cervical facet RF as the sole treatment modality, produced 61% -74% complete pain relief with a median duration of 15-17 months in patients who had responded to facet joints diagnostic block (10).

One more study in 2012 has demonstrated high voltage P-RF had a higher short-term effect compare to usual voltage, but results are still lower than C-RF (11). A double blind randomized prospective study has illustrated P-RF did not show any success rate in 6 months pain control, whereas C-RF had 95% pain control for trigeminal neuralgia (12).

Cohen in a recent study has compared P-RF with steroid injection for occipital neuralgia or migraine with occipital nerve tenderness (13). Six weeks pain relief was 61% in P-RF group, and 36% in steroid injection group, with a positive outcome of 34%, and 26% respectively (13). One study on 2010 had reached to 52.6%, 6 months pain improvement on occipital neuralgia (14).

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Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    18 to 90

Critères de participation

Inclusion Criteria:

Age 18-90;

Pain duration \> 3 months

Cervical, Shoulder pain or cevicogenic Headache per Pain Diagram;

Two single blinded facet medial branch blocks (MBB) performed 30 days prior to the facet RF;

Subjects show 50% and more pain relief after each MBB (using VAS for this assessment);

Unsuccessful or poorly tolerated previous treatments including: pain control medications, chiropractic, osteopathy, massage therapy, physiotherapy, acupuncture, aqua therapy, Botox injection, and trigger point injection;

Exclusion Criteria:

Non-English speakers;

Refusal to sign informed consent;

Less than 50% pain relief after MBB (using VAS);

Variation in the dose of concomitant pain control medication less than 4 weeks before the procedure;

Allergy to medication or radiology contrast;

Patients with coagulation issues, those currently using anticoagulants and didn't stop them based on Allevio clinic's policy for anticoagulants;

Pregnant patients;

Any pain interventions including previous RF, MBB, infusions 90 days prior to the first MBB for the same area (Except failed Botox injection, and trigger point injection);

Lieu de l'étude

Allevio Pain Management
Allevio Pain Management
Toronto, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Ramin Safakish, MD, FRCPC

[email protected]
6474788462
Backup Contact

Imrat Sohanpal, MD, FRCPC

[email protected]
6474788462
Allevio Pain Management Clinic
Allevio Pain Management Clinic
Toronto, Ontario
Canada

Contactez l'équipe d'étude

Backup Contact

Shadi Babazadeh, MD

[email protected]
6474788462
Primary Contact

Ramin Safakish, MD. FRCPC

[email protected]
6474788462
Étude parrainée par
Allevio Pain Management Clinic
Participants recherchés
Plus d'informations
ID de l'étude: NCT04124445