507: Pulsed radiofrequency adjacent to Cervical Dorsal Root ganglion for refractory phantom limb pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Developing methodology/technology, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Pain in Special Populations

Background and Aims: Phantom limb pain is defined as painful sensation referring to missing limb. Multiple modalities including medical and interventional therapies has been tried so far with minimal success. This single arm intervetional study aimed to evaluate the effect of pulsed radiofrequency (PRF) adjacent to cervical dorsal root ganglion (DRG) in patients with refractory upper extremity phantom limb pain.

Methods: This interventional study enrolled 27 patients with upper-extremity phantom limb pain presenting between March 2022 and March 2023 who had inadequate relief with antineuropathic medications. After written informed consent, standard ASA monitoring, a radiofrequency cannula was placed under strict asepsis using fluoroscopic (C-arm) guidance. Needle position was confirmed in all views, followed by sensory and motor stimulation. Two cycles of pulsed radiofrequency (120 seconds each, 2 Hz) were delivered, limiting tip temperature to 42°C. Outcomes (VAS, GPE, HADS) were assessed at 2 weeks, 1 and 3 months. Success was defined as >50% VAS reduction at 3 months (p<0.05 significant).

Results: The mean age was 47 years. Twenty one out of twenty-seven patients (77%) had excellent results with improvement in the VAS, GPE, and HADS scores at 3 months, which was also statistically significant. This was also clinically significant as the dose of antineuropathic medications was reduced more than 50 percent of the pre intervention dose.

Conclusions: PRF on adjacent cervical DRG may be an effective and safe method of managing refractory phantom limb pain. However, more long-term follow-up and larger patients are needed to establish the effectiveness of PRF treatment on refractory phantom limb pain.

References: 1.Gan D, Wang SY, Liu K, Zhang SY, Huang H, Xing JH, Qin CH, Wang KY, Wang T. Innovative exploration of phantom limb pain treatment based on extended reality technology. World J Orthop. 2025 Jun 18;16(6):107422.
2.Brzeziński K, Rękas-Dudziak AR, Maruszewska A. Pulsed radiofrequency as alternative method for phantom pain treatment. Case report. Clin Case Rep. 2020 Jul 20;8(10):2060-2062.

Presenting Author: Dr suyashi
Submitting Author: Suyashi LKU

Senior Author: Dr Ravi Shankar Sharma

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Dr. Ravi shankar Sharma: M.d. - AIIMS Gorakhpur