Ultrasound-guided high-voltage vs conventional pulsed radiofrequency in elderly cervical radiculopathy: A randomized controlled trial

Does higher-voltage pulsed radiofrequency to the cervical nerve root outperform standard-voltage treatment for pain and function in older adults with cervical radiculopathy?

104 randomized — what this means (101 treated) patients aged 60-85 with cervical radiculopathy at a single center

Assessor-blinded — what this means parallel-group RCT — what this means, 1:1 to ultrasound-guided high-voltage (70 V) vs conventional (45 V) pulsed radiofrequency, followed at 1 week, 1 and 3 months (responder data through 6 months)

• Arm radiating pain (NRS) improved more with high-voltage at 3 months: adjusted mean difference — what this means 1.24 (95% CI — what this means 0.46–2.02), P=0.002
• Neck Disability Index favored high-voltage at 3 months: adjusted mean difference — what this means 6.47 (95% CI — what this means 2.11–10.83), P=0.004
• ≥50% pain reduction: 68.75% vs 42.22% at 3 months (OR 3.01, P=0.011) and 65.22% vs 43.18% at 6 months (OR 2.52, P=0.035)
• Less rescue analgesic use with high-voltage between 1 and 3 months (P<0.05); adverse events — what this means similar (27.45% vs 32.00%)

In older adults with cervical radiculopathy, higher-voltage ultrasound-guided pulsed radiofrequency was associated with greater and longer-lasting pain and disability improvement than conventional voltage without added adverse events — what this means, which may shape the symptom picture of patients arriving for concurrent rehabilitation.