Efficacy of a Novel Ultrasound-Guided C8 Dorsal Root Ganglion Puncture Approach and Radiofrequency Treatment for Postherpetic Neuralgia.

PURPOSE: While pulsed radiofrequency ablation of spinal nerve roots, particularly targeting the dorsal root ganglion (DRG), has been established for postherpetic neuralgia (PHN), the C8 DRG remains underrepresented in clinical literature due to its unique anatomical constraints. Limited studies address the technical feasibility and efficacy of C8 DRG intervention in both domestic and international practice. This study introduces a novel puncture approach of ultrasound-guided C8 dorsal root ganglion pulsed radiofrequency to evaluate its clinical efficacy and safety of in patients with refractory postherpetic neuralgia.

PATIENTS AND

METHODS

A retrospective analysis was conducted on 17 patients from March 2023 through May 2025 meeting the diagnostic criteria of the Chinese Expert Consensus on the Diagnosis and Management of Postherpetic Neuralgia treated at the Pain Department of Taihe Hospital, Shiyan, Hubei Province were enrolled. All patients underwent the treatment of the puncture approach of ultrasound-guided C8 dorsal root ganglion pulsed radiofrequency. Visual Analog Scale (VAS) scores were recorded and compared preoperatively, at postoperative 48h, and at 1 week, 1 and 3 months postoperatively. The Athens Insomnia Scale (AIS) was used to evaluate changes in sleep quality, and the Generalized Anxiety Disorder 7-item scale (GAD-7) was employed to assess emotional status.

RESULTS

All patients underwent the procedure successfully with no severe complications. At 3-month follow-up, median scores showed significant reductions across all outcome measures (Friedman test, all p<0.001): VAS was 7.0 (IQR 7.0-8.0) to 1.0 (IQR 1.0-1.0) (χ 2 =65.43, df = 4), AIS was 8.0 (IQR 7.0-12.0) to 2.0 (IQR 2.0-3.0) (χ 2 =38.72, df = 4), and GAD-7 was 7.0 (IQR 6.0-10.0) to 2.0 (IQR 2.0-3.0) (χ 2 =54.74, df = 4). These results indicate that the procedure may offer meaningful clinical benefits, particularly in pain relief, insomnia improvement, and anxiety reduction in these patients.

LIMITATIONS: Retrospective study, comparator group absence, and patients who underwent radiofrequency treatment were concurrently taking neuropathic pain medications, injected the corticosteroid during the procedure, so subsequent score improvements cannot be definitively attributed to pulsed radiofrequency therapy alone.

CONCLUSION

This retrospective study preliminarily suggests that ultrasound-guided C8 dorsal root ganglion pulsed radiofrequency therapy may demonstrate favorable safety and potential efficacy.