Turkish Neurosurgery 2023 , Vol 33 , Num 1
Efficacy of Combined Dorsal Root Ganglion Pulsed Radiofrequency and Cervical Epidural Steroid Injection on Radicular Neck Pain
Ayse KINCI1,Sinem SARI2,Esra ERTILAV3,Osman Nuri AYDIN4
1Babaeski State Hospital, Department of Anesthesiology and Reanimation, Kirklareli, Turkey
2Adnan Menderes University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Aydin, Turkey
3Mehmet Akif Ersoy State Hospital, Department of Neurology, Division of Algology, Canakkale, Turkey
4Adnan Menderes University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Algology, Aydin, Turkey
DOI : 10.5137/1019-5149.JTN.36295-21.3 AIM: To evaluate the efficacy and safety of combined transforaminal anterior epidural steroid injection (TAESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) therapy on the radicular neck pain.

MATERIAL and METHODS: The results of 84 patients with cervical radicular pain who underwent combined DRG-PRF and TAESI under fluoroscopy were evaluated retrospectively. Primer outcome is the pain measurements of the patients before and after the procedure at the 1st, 3rd, and 6th months were evaluated with the Verbal Pain Scale (VPS). Our secondary outcome was the evaluation of patient satisfaction in the 1st, 3rd, and 6th months after the interventional treatment, and it was considered significant if it was evaluated as ?good? above 50%.

RESULTS: We found statistically significant decrease in the pain scores of the patients in the 1st, 3rd, and 6th months compared to the pre-intervention (VPS 0) (p<0.001). After the procedure, the patients expressed their satisfaction level as 69.1% at the 1st month, 71.5% at the 3rd month, and 72.6% at the 6th month as ?very good/good?. While the operation was mostly performed at the C5-6 level on both sides, it was seen that 61.9% of the operations were applied from the right side and 38.1% from the left side. No adverse effects or fatal neurological complications were observed.

CONCLUSION: Although the efficacy and complications of cervical TAESI and DRG-PRF treatment are controversial in the literature, we think that this combined treatment can provide effective pain palliation in experienced hands with appropriate patient selection, considering the risk / benefit ratio. Keywords : Radicular pain, Chronic pain, Pulse radiofrequency, Cervical epidural injection, Dorsal root ganglion

Corresponding author : Esra ERTILAV, eertilav@gmail.com