Comparative outcomes of ultrasound- and fluoroscopy-guided cervical medial branch pulsed radiofrequency in chronic facet joint pain: A retrospective cohort study.

Authors

Çile Aktan, Ece Yanık

Published in

Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology. Volume 38. Issue 3. Pages 147-157. Jul 01, 2026. Epub Jun 16, 2026.

Abstract

This study aims to compare clinical outcomes, procedural efficiency, and safety of pulsed radiofrequency (PRF) of the cervical medial branches performed under ultrasound (US) versus fluoroscopy (FL) guidance.
This single-center, retrospective cohort study included a total of 177 patients between January 2023 and June 2025. The patients were allocated to FL- (n = 75) or US-guided groups (n = 102). The Numeric Rating Scale (NRS), Neck Disability Index (NDI), and monthly analgesic use were assessed at baseline, at six weeks (primary endpoint), and at three and six months. The primary outcome inter-group NRS at six weeks was analyzed using analysis of covariance adjusted for baseline NRS, age, sex, bilaterality, and number of treated levels. Secondary outcomes included NDI, analgesic use, and procedural metrics. Six-week analyses included all patients; three- and six-month analyses used available-case data (up to n = 141). Last-observation-carried-forward (LOCF) sensitivity analyses were performed.
Of the 177 patients included in the study, 60 were male and 117 were female with a mean age of 53.47 ± 5.46 (range, 39 to 66) years. Compared to FL, US-guided PRF was associated with shorter procedure times (8.64 ± 0.93 vs. 14.41 ± 2.24 min), fewer needle redirections (1.36 ± 0.50 vs. 3.56 ± 1.02), and fewer minor complications (11.8% vs. 30.7%) (p ≤ 0.003 for all). At six weeks, adjusted mean NRS was 4.46 in US group versus 4.56 in FL group, with no significant inter-group difference (adjusted difference 0.10; 95% confidence interval [CI]: -0.53 to 0.34). No significant differences were observed for NDI or analgesic use at any time point. Responder, longitudinal mixed-effects, and LOCF sensitivity analyses yielded concordant results.
Our study results suggest that US- and FL-guided cervical medial branch PRF can yield similar clinical outcomes. However, US guidance provides procedural and safety advantages without compromising effectiveness.

PMID:
42550969
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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