CT-Guided Dorsal Root Ganglion Pulsed Radiofrequency Alone, with Ozone, or with Platelet-Rich Plasma for Postherpetic Neuralgia: A Randomized Controlled Trial
In brief
Platelet-rich plasma with pulsed radiofrequency lowers pain by 2.5 points
In a single-center trial of 122 adults with postherpetic neuralgia, adding platelet-rich plasma to CT-guided dorsal root ganglion pulsed radiofrequency produced a 2.5-point greater drop in visual-analog pain scores at 90 days than radiofrequency alone, alongside better sleep, quality-of-life scores and lower inflammatory markers, without any PRP-related complications. Results are preliminary and need confirmation in larger multicenter studies.
- Journal
- Journal of pain research (Q1)
- Published
- 21 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Kai Cao, Jie Wu, JiaLei Zhang
- PMID
- 42502491
- DOI
- 10.2147/JPR.S605629
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (top studies of the week, 2 August 2026).
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (paper of the day, 27 July 2026): RCT of PRF ± ozone or PRP for post‑herpetic neuralgia
Abstract
BACKGROUND: Direct randomized evidence comparing dorsal root ganglion pulsed radiofrequency (PRF) alone, PRF plus ozone, and PRF plus platelet-rich plasma (PRP) for postherpetic neuralgia (PHN) remains limited. OBJECTIVE: To compare the 90-day efficacy and safety of computed tomography-guided dorsal root ganglion PRF alone, PRF plus ozone, and PRF plus PRP in patients with PHN. METHODS: This single-center randomized controlled trial was conducted at a pain-treatment center in Changzhi, China, from July to December 2025. Adults aged 50-70 years with single-segment PHN lasting >3 months were assigned 1:1:1 to PRF alone as the active control, PRF plus ozone, or PRF plus PRP. Outcomes were assessed at baseline and 30, 60, and 90 days. Outcomes included 10-cm Visual Analog Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), 12-Item Short Form Health Survey (SF-12), and neutrophil-to-lymphocyte ratio (NLR). Longitudinal outcomes were assessed using mixed-effects models with Holm-Bonferroni-adjusted pairwise comparisons. RESULTS: The complete-case/per-protocol population included 122 participants: 38 PRF alone, 43 PRF plus ozone, and 41 PRF plus PRP. Baseline characteristics were comparable. At 90 days, PRF plus PRP showed greater improvement in VAS than PRF alone and PRF plus ozone (mean differences, -2.49 [95% CI, -2.88 to -2.10] and -1.43 [-1.80 to -1.05]), PSQI (-5.72 [-7.09 to -4.36] and -4.77 [-6.09 to -3.44]), SF-12 (20.91 [17.44 to 24.38] and 17.72 [14.35 to 21.08]), and NLR (-0.89 [-1.30 to -0.47] and -1.00 [-1.40 to -0.59]); all adjusted P values were <0.001. No PRP-related complications were observed. CONCLUSION: PRF plus PRP was associated with greater 90-day multidimensional improvement than PRF alone or PRF plus ozone. Given the single-center design, these results should be regarded as preliminary and require validation in larger, well-designed multicenter randomized trials.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.