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

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.