Research Progress on Low-Temperature Plasma Nucleoplasty and Targeted Radiofrequency for Cervical Spondylotic...

Cervical spondylotic radiculopathy (CSR) is a common neurological condition caused by compression or inflammation of cervical nerve roots, often resulting in significant pain and functional impairment. While many patients improve with conservative management, a substantial subset remains refractory and requires further intervention. Over the past 2 decades, minimally invasive percutaneous techniques have emerged as effective alternatives to conventional open surgery. This review synthesizes contemporary evidence on two key modalities: percutaneous cervical nucleoplasty (PCN), a decompressive procedure utilizing low-temperature plasma (coblation) technology to reduce intradiscal pressure, and pulsed radiofrequency (PRF) applied to the dorsal root ganglion, a neuromodulatory approach that modulates pain signaling without tissue destruction. Drawing on observational studies, randomized controlled trials, and systematic reviews, the article evaluates the clinical efficacy, safety, and durability of each technique, compares their outcomes with anterior cervical discectomy and fusion, and explores emerging combination strategies. Evidence indicates that both PCN and PRF provide significant and sustained pain relief with favorable safety profiles. PCN achieves long-term outcomes comparable to surgery in carefully selected patients with contained disc herniations, while PRF offers superior duration of relief compared with steroid injections alone. Emerging data support the synergistic use of PCN and PRF, as well as augmentation with intradiscal collagenase or ozone. Patient selection-guided by symptom duration, imaging characteristics, and predictive factors-remains critical for optimizing outcomes. Despite encouraging results, the evidence base is limited by study heterogeneity and moderate-to-low certainty. Future large-scale, multicenter randomized trials are needed to refine patient selection, optimize technical parameters, and establish comparative effectiveness. Overall, PCN and PRF represent valuable, minimally invasive options within a stepped-care approach to CSR, bridging conservative management and open surgery.