Health Problem: Cervical radicular pain may be caused by cervical degenerative disc disease, herniated disc, spinal stenosis, and foraminal stenosis. Symptoms include pain with upper extremity radiation, paresthesias in the arm or hand in conjunction with diminished muscle tendon reflexes, sensory loss, or motor weakness. Symptoms most often follow the distribution pattern of a specific nerve root.
Technology Description: A dorsal root ganglion (DRG) is a cluster of nerve cell bodies in the posterior roots of spinal nerves. DRG are known to participate in the pain signaling process. Pain signals coming from the periphery traverse the DRG to the spinal cord and subsequently to the brain. Pulsed radiofrequency (PRF) application to the DRG is a minimally invasive pain-management procedure. The goal of PRF is to provide pain control without the tissue destruction and painful sequelae associated with continuous radiofrequency ablation. The mechanism of action of PRF in pain relief is uncertain but it may be related to the effects of PRF on the electrical fields.
Controversy: PRF application to the DRG represents a minimally invasive treatment option for patients suffering from cervical radicular pain that has not responded to conservative measures. PRF avoids the indiscriminate nerve and adjacent tissue damage inherent with continuous radiofrequency ablation. Likewise, PRF lacks the potential for serious adverse effects associated with intrathecal steroid injections. However, the efficacy and durability of the treatment and the criteria for patient selection have not been established.
Key Questions:
- Does PRF application to the DRG provide pain relief, reduce the need for additional intervention, and reduce disability or improve function in patients with cervical radicular pain?
- How does PRF application to the DRG compare with alternative treatments for cervical radicular pain?
- Is PRF application to the DRG for cervical radicular pain safe?
- Have definitive patient selection criteria been identified for PRF application to the DRG for cervical radicular pain?
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