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Regional Nerve Blocks in Anesthesia and Pain Therapy pp 239–246Cite as

(Pulsed) Radiofrequency Treatment Adjacent to the Cervical Dorsal Root Ganglion

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Abstract

Radiofrequency (RF) treatment adjacent to the cervical dorsal root ganglion (DRG) is particularly indicated for the management of cervical radicular pain, refractory to conventional treatment. Cervical radicular pain is pain perceived in the arm, shooting or electric in quality, caused by irritation and/or injury of a cervical spinal nerve [1, 2]. It affects approximately 1 in 1,000 adults annually. There may be confusion between cervical radicular pain and cervical radiculopathy. The latter is a condition where an objective loss of sensory and/or motor function is present. Radicular pain and radiculopathy are therefore not synonymous, although they are frequently not differentiated in the literature. The former is a symptom caused by ectopic impulse generation. The latter also includes neurological signs. The two conditions may nonetheless coexist and may be caused by the same clinical entities, e.g., foraminal stenosis, intervertebral disc herniation, and radiculitis due to arteritis, infection, or inflammatory exudates [3]. The two syndromes can be part of a continuum, and radiculopathy may follow radicular pain as the underlying disease progresses.

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References

  1. Rathmell JP, Aprill C, Bogduk N. Cervical transforaminal injection of steroids. Anesthesiology. 2004;100(6):1595–600.

    Article  PubMed  Google Scholar 

  2. Bogduk N. Medical management of acute cervical radicular pain: and evidence-based approach. 1st ed. Newcastle: The Newcastle Bone and Joint Institute; 1999.

    Google Scholar 

  3. Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press; 1994.

    Google Scholar 

  4. Saal JS, Saal JA, Yurth EF. Nonoperative management of herniated cervical intervertebral disc with radiculopathy. Spine. 1996;21(16):1877–83.

    Article  CAS  PubMed  Google Scholar 

  5. Devereaux MW. Neck and low back pain. Med Clin North Am. 2003;87(3):643–62.

    Article  PubMed  Google Scholar 

  6. Bland J. Cervical spine syndromes. J Muscoloskel Med. 1986;3:23–41.

    Google Scholar 

  7. Dwyer A, Aprill C, Bogduk N. Cervical zygapophysial joint pain patterns. I: A study in normal volunteers. Spine. 1990;15(6):453–7.

    Article  CAS  PubMed  Google Scholar 

  8. Schellhas KP, Smith MD, Gundry CR, Pollei SR. Cervical discogenic pain. Prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine. 1996;21(3):300–11; discussion 11–2.

    Article  CAS  PubMed  Google Scholar 

  9. Date E, Gray L. Electrodiagnostic evidence for cervical radiculopathy ans suprascapular neuropathy in shoulder pain. Electromyogr Clin Neurophysiol. 1996;36:333–9.

    CAS  PubMed  Google Scholar 

  10. Fager CA. Identification and management of radiculopathy. Neurosurg Clin N Am. 1993;4(1):1–12.

    CAS  PubMed  Google Scholar 

  11. Spurling R, Scoville W. Lateral rupture of the cervical intervertebral discs: a common cause of shoulder and arm pain. Surg Gynecol Obstet. 1944;78:350–8.

    Google Scholar 

  12. Davidson RI, Dunn EJ, Metzmaker JN. The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies. Spine. 1981;6(5):441–6.

    Article  CAS  PubMed  Google Scholar 

  13. Rothstein J, Roy S, Wolf S. The rehabilitation specialist’s handbook. Philadelphia: FA Davis; 1991.

    Google Scholar 

  14. Viikari-Juntura E, Porras M, Laasonen EM. Validity of clinical tests in the diagnosis of root compression in cervical disc disease. Spine. 1989;14(3):253–7.

    Article  CAS  PubMed  Google Scholar 

  15. Elvey R. The investigation of arm pain: signs and adverse responses to the physical examination of the brachial plexus and related tissues. In: Boyling J, Palastanga N, editors. Grieve’s modern manual therapy. New York: Churchill Livingstone; 1994. p. 557–85.

    Google Scholar 

  16. Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine. 2002;27(2):156–9.

    Article  PubMed  Google Scholar 

  17. Mogil JS. The genetic mediation of individual differences in sensitivity to pain and its inhibition. Proc Natl Acad Sci U S A. 1999;96(14):7744–51.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Mogil JS, Wilson SG, Bon K, Lee SE, Chung K, Raber P, Pieper JO, Hain HS, Belknap JK, Hubert L, Elmer GI, Chung JM, Devor M. Heritability of nociception II. ‘Types’ of nociception revealed by genetic correlation analysis. Pain. 1999;80(1–2):83–93.

    Article  CAS  PubMed  Google Scholar 

  19. Daffner SD, Hilibrand AS, Hanscom BS, Brislin BT, Vaccaro AR, Albert TJ. Impact of neck and arm pain on overall health status. Spine. 2003;28(17):2030–5.

    Article  PubMed  Google Scholar 

  20. Van Zundert J, Raj P, Erdine S, van Kleef M. Application of radiofrequency treatment in practical pain management: state of the art. Pain Pract. 2002;2(3):269–78.

    Article  PubMed  Google Scholar 

  21. Kerns RD, Habib S. A critical review of the pain readiness to change model. J Pain. 2004;5(7):357–67.

    Article  PubMed  Google Scholar 

  22. Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther. 2000;30(12):728–44.

    Article  CAS  PubMed  Google Scholar 

  23. Slappendel R, Crul BJ, Braak GJ, Geurts JW, Booij LH, Voerman VF, de Boo T. The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40 degrees C and 67 degrees C treatments. Pain. 1997;73(2):159–63.

    Article  CAS  PubMed  Google Scholar 

  24. van Kleef M, Liem L, Lousberg R, Barendse G, Kessels F, Sluijter M. Radiofrequency lesion adjacent to the dorsal root ganglion for cervicobrachial pain: a prospective double blind randomized study. Neurosurgery. 1996;38(6):1127–31; discussion 31–2.

    PubMed  Google Scholar 

  25. Geurts J, van Wijk RM, Stolker R, Groen GJ. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg Anesth Pain Med. 2001;26:394–400.

    CAS  PubMed  Google Scholar 

  26. Niemisto L, Kalso E, Malmivaara A, Seitsalo S, Hurri H. Radiofrequency denervation for neck and back pain. A systematic review of randomized controlled trials. Cochrane Database Syst Rev. 2003;(1):CD004058.

    Google Scholar 

  27. Sluijter ME, Cosman ER, Rittman IIWB, van Kleef M. The effects of pulsed radiofrequency field applied to the dorsal root ganglion – a preliminary report. Pain Clin. 1998;11(2):109–17.

    Google Scholar 

  28. Van Zundert J, Lamé IE, de Louw A, Jansen J, Kessels F, Patijn J, van Kleef M. Percutaneous pulsed radiofrequency treatment of the cervical dorsal root ganglion in the treatment of chronic cervical pain syndromes: a clinical audit. Neuromodulation. 2003;6(1):6–14.

    Article  PubMed  Google Scholar 

  29. Van Zundert J, Patijn J, Kessels A, Lame I, van Suijlekom H, van Kleef M. Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: a double blind sham controlled randomized clinical trial. Pain. 2007;127:173–82.

    Article  PubMed  Google Scholar 

  30. van Kleef M, Spaans F, Dingemans W, Barendse GAM, Floor E, Sluijter ME. Effects and side effects of a percutaneous thermal lesion of the dorsal root ganglion in patients with cervical pain syndrome. Pain. 1993;52:49–53.

    Article  PubMed  Google Scholar 

  31. Ford DJ, Pither C, Raj PP. Comparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator. Anesth Analg. 1984;63(10):925–8.

    Article  CAS  PubMed  Google Scholar 

  32. Rowlingson JC. Epidural steroids: do they have a place in pain management? Barcelona: V. Permanyer Publications; 1996.

    Google Scholar 

  33. Hession WG, Stanczak JD, Davis KW, Choi JJ. Epidural steroid injections. Semin Roentgenol. 2004;39(1):7–23.

    Article  PubMed  Google Scholar 

  34. Fouyas IP, Statham PF, Sandercock PA. Cochrane review on the role of surgery in cervical spondylotic radiculomyelopathy. Spine. 2002;27(7):736–47.

    Article  PubMed  Google Scholar 

  35. Persson LC, Lilja A. Pain, coping, emotional state and physical function in patients with chronic radicular neck pain. A comparison between patients treated with surgery, physiotherapy or neck collar–a blinded, prospective randomized study. Disabil Rehabil. 2001;23(8):325–35.

    Article  CAS  PubMed  Google Scholar 

  36. Jacobs W, Anderson P, Limbeek J, Willems P, Pavlov P. Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Syst Rev. 2004;(4):CD004958.

    Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Multidisciplinary Pain Centre, Ziekenhuis Oost-Limburg, Genk, Belgium

    Jan Van Zundert MD, PhD, FIPP, M. Puylaert MD, FIPP, P. Van Elderen MD, FIPP & P. De Vooght MD

  2. Department of Anesthesiology and Pain Management, University Hospital Maastricht, 6202 A2, Maastricht, The Netherlands

    Jan Van Zundert MD, PhD, FIPP

  3. Department of Anesthesiology and Pain Centre, AZ Nikolaas, St. Niklaas, Belgium

    K. Van Boxem MD, FIPP

  4. Department of Anesthesiology and Pain Management, University Hospital Maastricht, Maastricht, The Netherlands

    M. van Kleef MD, PhD, FIPP

Authors
  1. Jan Van Zundert MD, PhD, FIPP
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  2. M. Puylaert MD, FIPP
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  3. K. Van Boxem MD, FIPP
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  4. P. Van Elderen MD, FIPP
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  5. P. De Vooght MD
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  6. M. van Kleef MD, PhD, FIPP
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Corresponding author

Correspondence to Jan Van Zundert MD, PhD, FIPP .

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Van Zundert, J., Puylaert, M., Van Boxem, K., Van Elderen, P., De Vooght, P., van Kleef, M. (2015). (Pulsed) Radiofrequency Treatment Adjacent to the Cervical Dorsal Root Ganglion. In: Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-05131-4_18

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  • DOI: https://doi.org/10.1007/978-3-319-05131-4_18

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-05130-7

  • Online ISBN: 978-3-319-05131-4

  • eBook Packages: MedicineMedicine (R0)

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