Combined Continuous and Pulsed Radiofrequency Ablation for Pain Relief and Their Safety in Cervical Facet Pain

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

Inclusion Criteria: * Patients age from (30-75) years. * American Society of Anesthesiologists (ASA) physical status class I or II * ≥ 4 points on the verbal numeric rating scale (VNRS) (scored from 0 = no pain to 100 = worst pain imaginable)) before RF stimulation of the cervical medial branches; * Patients presenting with a positive diagnostic cervical medial branche block defined as pain relief more than 50% from baseline. Exclusion Criteria: * Repeated cervical radiofrequency ablation. * Patients presenting neck pain with radicular symptoms. * Previous cervical discectomy or fixation surgery. * Malignancy. * local infection * Psychological problem. * language barrier. * History of allergy to radio-opaque contrast solution,lidocaine or bupivacaine. - Inadequate medical proplem (hepatic, renal, cardiac) patients.