An interventional study of Flouroscopic guidance cervical medial branch radiofrequency ablation in Radiofrequency Ablation, sponsored by Fayoum University Hospital. Completed at 1 site in Egypt. Open to participants aged 30 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-23.
Sponsored by Fayoum University Hospital · Not applicable, Interventional, and Treatment
Continuous radiofrequency ablation (CRF) is the effective management for cervical facet joint pain but related with neuropathic symptoms in post-radiofrequency period. Additionally, pulse radiofrequency ablation (PRF) provides relief of neuropathic symptoms. However, the effect of CRF followed by PRF has yet to be validated
One prevalent and incapacitating problem seen in pain treatment therapy is chronic neck pain originating from the cervical facet joints. (1). Cervical facet joint pain was shown to be 49% common in a recent study (2). Depending on the level of the cervical facet joint, a facet referral pattern is characteristic of cervical facet joint discomfort (3,4). Radiofrequency (RF) ablation of the medial branch nerves is a proven, minimally invasive therapeutic option for long-lasting pain alleviation once a good response to diagnostic cervical medial branch blocks validates the diagnosis. Cervical facet joint pain has been successfully treated with traditional continuous radiofrequency ablation (RFA) of the cervical medial branches (5). Regretfully, even with sufficient analgesia, over 40% of patients undergoing RFA experience negative side effects, including post-procedural sensory side effects like numbness, dysesthesia, and hypersensitivity. 6,7). As a result, Continuous radiofrequency ablation (CRF) is the established minimally invasive treatment for chronic facet-mediated spinal pain once diagnostic medial branch blocks confirm the pain source, producing a thermal lesion at the target nerve to interrupt nociceptive transmission. Manchikanti et al. rated continuous RFA as Level II evidence for managing chronic spinal pain from the facet joints, reflecting its established role in clinical practice (6). However, despite its efficacy, more than 40% of patients undergoing CRF of the cervical medial branches experience post-procedural sensory side effects such as numbness, dysesthesia, and hypersensitivity (7,8) prompting interest in alternative radiofrequency strategies that preserve analgesic benefit while reducing these neuropathic effects. Combining continuous and pulsed radiofrequency (CPRF) has been proposed as a strategy to preserve the analgesic effect achieved with thermal ablation while reducing the incidence of post-procedural neuropathic side effects through the added neuromodulatory pulsed phase (9). However, there are no studies comparing the effectiveness and safety of pulse versus combined radiofrequency ablation in the cervical facet joint. This study was designed to compare the effectiveness and safety of continuous radiofrequency (CRF) alone versus combined continuous and pulsed radiofrequency (CPRF) in patients with chronic cervical facet joint pain.
1,232 studies on the registry are indexed under Neck Pain; 254 are open to participants now.
This study's enrollment of 39 is below the median of 52 across 1,004 interventional studies indexed under Neck Pain.
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After the patient lying prone we obtaining the posterior approach with PA view then lateral 15 degrees the C shaped edge of the cervical vertebrae were appeared and then we advance the needle till reaching this C shaped till hitting the bone then slipping the active tip slightly therafter we obtaining lateral view to determine the depth of the needle over the cervical pedicle. patients in the continous radiofrequency group will be underwent continous radiofrequency at 80°C for 90 seconds for 2 cycles
Procedure: Flouroscopic guidance cervical medial branch radiofrequency ablation
After the patient lying prone we obtaining the posterior approach with PA view then lateral 15 degrees the C shaped edge of the cervical vertebrae were appeared and then we advance the needle till reaching this C shaped till hitting the bone then slipping the active tip slightly therafter we obtaining lateral view to determine the depth of the needle over the cervical pedicle. patients in the continous and pulsed group will be underwent continous and pulsed radiofrequency at 80°C for 90 seconds for 1 cycle followed by pulsed radiofrequency at 42°C for 120 seconds for 1 cycle
Procedure: Flouroscopic guidance cervical medial branch radiofrequency ablation
Electromagnetic wave deposition near nerve tissue for pain management
neck disability index pre and post-intervention between comparison groups
Neck disability index : It contains ten sectors: seven sectors related to everyday existing behaviors, two sectors correlated to pain, and one sector correlated to concentration. All items are marked from 0 to 5. A mark of 0 denotes the maximum level of function, while a mark of 5 indicates the bottom level of function. The maximum mark is 50, and a greater mark relates to an increased level of disability.
Time frame: 6 months
Duration of pain relief
The duration of pain relief was expressed as the period between pain relief and pain reoccurrence to 50% of pre-procedural pain level
Time frame: One month, 3months,6 months, 12 months
Complications
Numbness, dysethesia, drop head syndrome, hypersensitivity, ataxia
Time frame: One month, 3 months, 6months, 12 months
neck disability index pre and post-intervention between comparison groups
Neck disability index : It contains ten sectors: seven sectors related to everyday existing behaviors, two sectors correlated to pain, and one sector correlated to concentration. All items are marked from 0 to 5. A mark of 0 denotes the maximum level of function, while a mark of 5 indicates the bottom level of function. The maximum mark is 50, and a greater mark relates to an increased level of disability.
Time frame: One month
neck disability index pre and post-intervention between comparison groups
Neck disability index : It contains ten sectors: seven sectors related to everyday existing behaviors, two sectors correlated to pain, and one sector correlated to concentration. All items are marked from 0 to 5. A mark of 0 denotes the maximum level of function, while a mark of 5 indicates the bottom level of function. The maximum mark is 50, and a greater mark relates to an increased level of disability.
Time frame: 3 months
neck disability index pre and post-intervention between comparison groups
Neck disability index : It contains ten sectors: seven sectors related to everyday existing behaviors, two sectors correlated to pain, and one sector correlated to concentration. All items are marked from 0 to 5. A mark of 0 denotes the maximum level of function, while a mark of 5 indicates the bottom level of function. The maximum mark is 50, and a greater mark relates to an increased level of disability.
Time frame: 12 months
VAS SCORE
of procedure, visual analog scale (VAS;0-100)
Time frame: One month
VAS SCORE
of procedure, visual analog scale (VAS;0-100)
Time frame: 3 months
VAS SCORE
of procedure, visual analog scale (VAS;0-100)
Time frame: 12 months
VAS SCORE
of procedure, visual analog scale (VAS;0-100)
Time frame: 6 months
Age
in years
Time frame: 1 hour before procedure
Weight
in Kilogram
Time frame: 1 hour before procedure
Height
in centimeter
Time frame: 1 hour before procedure
Body mass index
in kilogram/m2
Time frame: 1 hour before procedure
Plan to share: No — Data will be given on resonable request
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Fayoum University Hospital