Cervical Radiofrequency Therapy

Abstract

The indication for radiofrequency therapy on the cervical spine can only be made on the basis of several selection criteria. The following pain patterns are found in the literature: Significant for complaints in the area of the facet joints at level C2/3 are side-emphasized pains in the area of the occiput. In the area C3/4, partly at the level of C4/5, complaints or pseudoradicular radiation into the upper part of the M. trapezius are to be expected, for the facet joint C5/6 rather pain in the transversus area or at the upper edge of the M. trapezius are significant. Concerning the joint at the level of C6/7, the complaints are localized in the dorsal part of the shoulder or the scapula. Clinically, the patients experience movement-dependent complaints, especially during lateral rotation and lateral inclination of the cervical spine. Manual diagnosis reveals swelling (multifidii muscle) above the relevant irritation points of the facet joints and corresponding painful insertion points at the linea nuchae. The absence of neurological deficits is to be required. Only the repeated blockade of the R. medialis with local anaesthetics (according to the criteria of the Spine Intervention Society) provides a clear diagnostic statement. In principle, all conservative treatment options should be exhausted before cervical radiofrequency therapy is performed. The pain should be present for more than 3 months and painkiller abuse should be excluded.