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Pulsed Radiofrequency of C2 Dorsal Root Ganglion Under Ultrasound-Guidance and CT Confirmed for Chronic Headache: Follow-Up of 20 Cases and Literature Review

Authors Li J, Yin Y, Ye L, Zuo Y

Received 5 September 2019

Accepted for publication 24 December 2019

Published 13 January 2020 Volume 2020:13 Pages 87—94

DOI https://doi.org/10.2147/JPR.S229973

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Michael A Überall


Jun Li, 1, 2 Yan Yin, 2 Ling Ye, 2 Yunxia Zuo 3

1National Clinical Research Center for Geriatrics and Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, People’s Republic of China; 2Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, People’s Republic of China; 3Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, People’s Republic of China

Correspondence: Ling Ye
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, People’s Republic of China
Tel +86-28-85423593
Email zerodq_hx@163.com

Background: Chronic headache is common but difficult to treat. Most patients respond poorly to drugs. Nerve block is an effective treatment but has no continuous effect. The pulsed radiofrequency (PRF) technique has been shown to be effective in relieving head pain and extending the effect of nerve block.
Objective: The purpose of this study is to evaluate the long-term efficacy of C2 dorsal root ganglion after pulsed radiofrequency (PRF) guided by ultrasound for chronic headache.
Setting: The Department of Pain Management, West China Hospital.
Methods: Twenty patients who did not respond to medications and peripheral nerve blocks underwent ultrasound-guided PRF of the C2 dorsal root ganglion. The patients were followed up for 6 months. Visual analog scale (VAS) score was evaluated at 1 week, 1 month, 3 months, and 6 months. The quality of life (QOL) was assessed by Brief Pain Inventory (BPI) scores which were rated at pre-procedure and 1 month, 3 months, and 6 months after the procedure. The occurrence of complications was evaluated and reported.
Results: Mean VAS scores were significantly decreased at 1 week, 1 month, 3 months and 6 months compared to the pre-procedure mean VAS score. Mean BPI scores decreased significantly at each postoperative time point compared to the preoperative baseline and low scores remained throughout the follow-up period: 45.05± 3.44 at pre-procedure, 10.60 ± 2.37 at 1 weeks, 12.50 ± 2.46 at 1 month, 12.90 ± 2.62 at 3 months, and 11.63 ± 2.98 at 6 months. Mild complications occurred, including 1 case (4.7%) of transient cervicalgia (lasting for 24 hrs) and 3 cases (14.2%) of transient dizziness (lasting for 30 mins).
Limitations: Firstly, it included a small sample of patients. Another is the short duration of the follow-up.
Conclusion: C2 PRF may be considered as an alternative treatment for chronic headache.

Keywords: ultrasound guidance, pulsed radiofrequency, dorsal root ganglion, chronic intractable headache, translateral approach

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