Combined Ultrasound-guided Perineural Vitamin B12 Injection and Pulsed Radiofrequency of C2 Dorsal Root Ganglion for Treatment of C2 Postherpetic Neuralgia: A Case Report

Postherpetic neuralgia (PHN) is commonly associated with moderate-to-severe pain, hyperalgesia, and allodynia. The efficacy of standard treatments is often insufficient, leading to a substantial reduction in patients’ quality of life. This article proposes an innovative therapeutic strategy for C2 PHN. A 71-year-old woman with a 15-year history of refractory PHN localized to the C2 dermatome, unresponsive to various pharmacological and interventional treatments, exhibited significant symptom improvement following two sessions of combined ultrasound-guided perineural Vitamin B12 injections with pulsed radiofrequency (PRF) therapy targeting the C2 dorsal root ganglion (DRG). The combination of ultrasound-guided perineural Vitamin B12 injections and PRF of the C2 DRG demonstrates a synergistic effect and potential efficacy in treating C2 PHN. Further studies are necessary to confirm its effectiveness and safety.