Percutaneous radiofrequency neurotomy for chronic neck pain: Outcomes in a series of consecutive patients

Background. Randomized controlled trials in research settings have demonstrated the efficacy of percutaneous radiofrequency neurotomy of the medial branches of the cervical dorsal rami in the palliation of chronic zygapophysial joint pain, a common cause of chronic neck pain, but one that is under-recognized in some quarters. Aims. This study aimed to determine the outcomes of radiofrequency neurotomy in usual clinical practice for patients with established cervical zygapophysial joint pain. Methods. The study was conducted in a public hospital, incorporating the private practice and public clinic elements of a single physician. All patients who underwent radiofrequency neurotomy had a diagnosis of cervical zygapophysial joint pain established by controlled cervical medial branch blocks. The primary outcome of duration of pain relief was determined for all consecutive procedures performed during a two-year period. Data were collected by chart review and telephone contact by an independent assessor. Results. Forty-seven procedures were performed on 35 patients. Two patients were lost to follow-up. Twelve patients had two procedures. Thirty-six of 45 assessable procedures (80%) achieved significant pain relief. These 36 procedures achieved a mean duration of pain relief of 36 weeks, with a median of 35 weeks. Repeat procedures usually achieved reproducible pain relief. Most patients had significant postprocedural pain for about one week. Only one serious adverse event (local superficial infection) was reported. Conclusion. Radiofrequency neurotomy is an effective palliative treatment for chronic cervical zygapophysial joint pain when performed in routine clinical practice.