• RF FOR LUMBAR PAIN
• RF FOR SACROILIAC JOINT PAIN
• PULSED RF FOR RADICULAR PAIN
• RF FOR CEREVICAL PAIN

STUDY GOAL

To assess the effectiveness of pulsed radiofrequency (PRF) stimulation on the atlanto-occipital (AO) joint in patients with chronic joint pain. The authors also compared the effect of AO intra-articular (IA) PRF and AO-IA corticosteroid injection (ICI)

METHODOLOGY

Patients: 23 patients with spontaneous onset chronic upper cervical pain (suboccipital neck area) were prospectively recruited

• All patients failed to respond to conservative treatments (physical therapy and medication).
• Patients presented with a limited range of lateral flexion upon rotation of the AO joint and sustained pain for at least 6 months.

Study groups: Patients were randomized to receive either PRF (N=12) or ICI (N=11).Treatment was carried out by one experienced clinician.

• A Numeric Rating Scale (NRS) score was used to evaluate pain severity before treatment and 1,3, and 6 months after the procedure. Successful pain relief was defined as ≥50% reduction in baseline NRS score at 6 months.

AO-PRF procedure: A 22-gauge, 10-cm cannula with a 10-mm active tip (Cosman™ RF-CC10522) was inserted in the uppermost portion of the AO joint. PRF was performed with a Cosman™-G4 RF generator at 5Hz and 5ms pulse width for 360s at 55 V. Electrode tip temperature was maintained at or below 42°C.

AO-PRF procedure: A 25-gauge spinal needle was inserted into the AO joint. A mixture of anesthetic and corticosteroid was slowly injected.

RESULTS

• Chronic joint pain severity (mean NRS scores) was significantly reduced at 1, 3, and 6 months after each procedure (P<0.001).
• Successful pain relief was achieved in 66.7 % (8/12) of patients in the PRF group and 63.6 % (7/11) of the patients in the ICI group.
• The extent of pain reduction between the two procedures was not significantly different at 6 months post-treatment (P=0.879).