慢性疼痛颈段射频消融治疗患者的真实世界前瞻性结局评估(RAPID)。

Assessment of real-world, prospective outcomes in patients treated with cervical radiofrequency ablation for chronic pain (RAPID).

作者信息

Provenzano David A, Holt Bradley, Danko Michael, Atallah Joseph, Iqbal Maaz, Shah Binit, Singh Albert, Sachdeva Harsh, Donck Ella Ver, Liebrand Bart, Shaw Erik, Haas Sherri, Sekhar Rajat, Pan Ann, Halperin Daniel S, Goldberg Edward

机构信息

Pain Diagnostics and Interventional Care, Sewickley, PA, USA.

Tucson Orthopaedic Institute, Tucson, AZ, USA.

出版信息

Interv Pain Med. 2025 Aug 23;4(3):100623. doi: 10.1016/j.inpm.2025.100623. eCollection 2025 Sep.

Abstract

INTRODUCTION

Cervical facet joint syndrome (CFJS) is a common cause of chronic neck pain. While numerous studies have demonstrated the effectiveness of radiofrequency ablation (RFA) for facetogenic pain, its use in treating CFJS remains a subject of ongoing debate.

OBJECTIVE

Here, we sought to evaluate real-world clinical outcomes in cervical RFA-treated patients with chronic cervical facetogenic pain.

METHODS

The RAPID study (Clinicaltrials.gov identifier: NCT04673032) is an international, multicenter, prospective study of patients using a commercially-available radiofrequency ablation system for the treatment of chronic pain, provided per standard of care. Patients were monitored at study follow-up visits (1-, 3-. 6-, 12-, and 24-months post-index procedure). Key clinical endpoint measures collected and evaluated include numeric pain rating scale (NPRS), Oswestry Disability Index (functional disability, ODI), EQ-5D-5L (quality-of-life), and Patient Global Impression of Change (PGIC).

RESULTS

A total of 56 patients were enrolled in this cervical facetogenic pain cohort. At both 6 (n = 49) and 12 months (n = 40), mean NPRS pain scores significantly decreased from a baseline of 6.0 ± 1.9 to 3.3 ± 2.8 and 3.3 ± 2.2, respectively (p < 0.0001). Oswestry Disability Index (ODI) scores also improved, dropping by 7.9- and 9.7-points from a baseline of 32.7 (p < 0.0001). Treatment response rates (≥50 % pain relief) were 81 % at 1 month and 80 % at 12 months. Improvements in quality-of-life (EQ-5D-5L) and self-reported change (PGIC) were also consistently observed.

CONCLUSIONS

The cervical RFA cohort in the RAPID study demonstrated consistent, clinically meaningful improvements in pain, function, quality-of-life, and treatment satisfaction across all follow-up visits, underscoring the real-world effectiveness of RFA for appropriately selected patients with cervical facetogenic pain.

摘要

引言

颈椎小关节综合征(CFJS)是慢性颈部疼痛的常见原因。虽然众多研究已证明射频消融(RFA)治疗关节源性疼痛的有效性,但其在治疗CFJS中的应用仍是一个持续争论的话题。

目的

在此,我们试图评估接受颈椎RFA治疗的慢性颈椎关节源性疼痛患者的实际临床疗效。

方法

RAPID研究(Clinicaltrials.gov标识符:NCT04673032)是一项国际性、多中心、前瞻性研究,研究对象为使用市售射频消融系统按照标准治疗方案治疗慢性疼痛的患者。在研究随访(索引手术后1、3、6、12和24个月)时对患者进行监测。收集并评估的关键临床终点指标包括数字疼痛评分量表(NPRS)、Oswestry功能障碍指数(功能障碍,ODI)、EQ-5D-5L(生活质量)和患者总体改善印象(PGIC)。

结果

本颈椎关节源性疼痛队列共纳入56例患者。在6个月(n = 49)和12个月(n = 40)时,平均NPRS疼痛评分分别从基线的6.0±1.9显著降至3.3±2.8和3.3±2.2(p < 0.0001)。Oswestry功能障碍指数(ODI)评分也有所改善,从基线的32.7下降了7.9分和9.7分(p < 0.0001)。治疗有效率(疼痛缓解≥50%)在1个月时为81%,在12个月时为80%。生活质量(EQ-5D-5L)和自我报告的改善(PGIC)也持续可见。

结论

RAPID研究中的颈椎RFA队列在所有随访中均显示出疼痛、功能、生活质量和治疗满意度方面持续且具有临床意义的改善,强调了RFA对适当选择的颈椎关节源性疼痛患者的实际疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1de8/12398795/222ab566d24c/gr1.jpg

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