Advantages of Blunt Radiofrequency Needles in CT-Guided Dorsal Root Ganglion Pulsed Radiofrequency for the Treatment of Zoster-Associated Pain.

Abstract

Objective: Compare the clinical efficacy of CT-guided blunt versus sharp needles for dorsal root ganglion-pulsed radiofrequency (DRG-PRF) in treating zoster-associated pain (ZAP).

Method: This retrospective study analyzed 70 ZAP patients receiving CT-guided DRG-PRF between January 2021 and December 2024. Participants were divided into the blunt needle group (BNG, n = 30) and the sharp needle group (SNG, n = 40). Evaluated endpoints encompassed SF-MPQ scores, postoperative analgesia use, intraprocedural trajectory pain (NRS), operative time, number of CT scan slices, and incidence of complications.

Result: The BN group showed lower puncture NRS scores, shorter operative time, and fewer CT scan layers than the SN group (p < 0.05). SF-MPQ scores (PRI, VAS, and PPI) decreased in both groups postoperatively (p < 0.05), with lower PRI and PPI in the BN group at Day 1, Week 1, and Months 1 and 3 (p < 0.05). Pregabalin use was lower in the BN group at Months 3 and 6, and tramadol use was lower at Week 1 and Month 1 (p < 0.05).

Conclusion: CT-guided DRG-PRF demonstrates good analgesic efficacy in the treatment of ZAP. Compared with sharp needles, blunt needles show superior performance in terms of intraoperative puncture pain, procedure duration, radiation exposure, and postoperative medication use. As an optimized puncture instrument for DRG-PRF, the blunt needle holds promise for broader clinical application and warrants further promotion.

Trial registration: Chinese Clinical Trial Registry: ChiCTR2500102560.