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

Abstract Background 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. Methods 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. Results 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. Conclusions 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.