End-on Versus Parallel Radiofrequency Lesioning for Neurotomy of the Cervical Medial Branch Nerves

Launched by UNIVERSITY HEALTH NETWORK, TORONTO · Apr 5, 2023

Keywords

ClinConnect Summary

The EndPaRL study is researching two different techniques for treating chronic neck pain caused by arthritis in the neck joints. The two methods being compared are called end-on and parallel radiofrequency lesioning, which involve using a special needle to create heat around specific nerves to help reduce pain. This study aims to find out which technique works better for patients suffering from moderate to severe neck pain that has not improved with other treatments, like medication or physical therapy.

To participate in the trial, you need to be an adult between 18 and 85 years old and have had neck pain for at least three months. Your pain should be rated at 5 out of 10 or higher, and imaging tests must show signs of arthritis in the neck joints. Additionally, you should have tried other treatments without success. If you join the study, you will receive one of the two treatments and be monitored to see how well it helps your pain. It's important to know that certain conditions, such as severe mental health issues or pregnancy, may prevent you from participating.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Adult patient of either gender aged 18-85 years
• • 2. Predominant axial (non-radicular) neck pain for at least 3 months
• • 3. 7-day average NRS score for neck pain ≥ 5/10 at baseline evaluation
• • 4. Moderate or greater functional impairment due to pain, defined as NDI Questionnaire raw score of 15 out of 50 (≥30% )e Failure to respond to conservative medical management (pharmacologic, physical therapy) for at least 3 months;
• • f) Positive response to two consecutive diagnostic blocks of the CMBN with a short and long-acting anesthetic
• Exclusion Criteria:
• • 1. Participants with financial incentives or litigation associated with ongoing pain
• • 2. Inability to complete assessment instruments
• • 3. Chronic widespread pain
• • 4. Prior RFN of the CMBN;
• • 5. Severe mental health issues
• • 6. Pregnancy or other reason that precludes the use of fluoroscopy
• • 7. Untreated coagulopathy
• • 8. Systemic or local infection at the time of screening.