下颈椎内侧支射频神经切断术对颈源性头痛的影响
The effect of radiofrequency neurotomy of lower cervical medial branches on cervicogenic headache.
作者信息
Park Seung Won, Park Yong Sook, Nam Taek Kyun, Cho Tack-Geun
机构信息
Department of Neurosurgery, Spine Center, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea.
出版信息
J Korean Neurosurg Soc. 2011 Dec;50(6):507-11. doi: 10.3340/jkns.2011.50.6.507. Epub 2011 Dec 31.
OBJECTIVE
Cervicogenic headache (CGH) is known to be mainly related with upper cervical problems. In this study, the effect of radiofrequency neurotomy (RFN) for lower cervical (C4-7) medial branches on CGH was evaluated.
METHODS
Eleven patients with neck pain and headache, who were treated with lower cervical RFN due to supposed lower cervical zygapophysial joint pain without symptomatic intervertebral disc problem or stenosis, were enrolled in this study. CGH was diagnosed according to the diagnostic criteria of the cervicogenic headache international study group. Visual analogue scale (VAS) score and degree of VAS improvement (VASi) (%) were checked for evaluation of the effect of lower cervical RFN on CGH.
RESULTS
The VAS score at 6 months after RFN was 2.7±1.3, which were significantly decreased comparing to the VAS score before RFN, 8.1±1.1 (p<0.001). The VASi at 6 months after RFN was 63.8±17.1%. There was no serious complication.
CONCLUSION
Our data suggest that lower cervical disorders can play a role in the genesis of headache in addition to the upper cervical disorders or independently.
目的
已知颈源性头痛（CGH）主要与上颈椎问题有关。在本研究中，评估了射频神经切断术（RFN）对下颈椎（C4 - 7）内侧支治疗CGH的效果。
方法
本研究纳入了11例因假定的下颈椎关节突关节疼痛而接受下颈椎RFN治疗且无椎间盘症状性问题或狭窄的颈部疼痛和头痛患者。根据颈源性头痛国际研究组的诊断标准诊断CGH。检查视觉模拟量表（VAS）评分和VAS改善程度（VASi）（%）以评估下颈椎RFN对CGH的疗效。
结果
RFN术后6个月的VAS评分为2.7±1.3，与RFN术前的VAS评分8.1±1.1相比显著降低（p<0.001）。RFN术后6个月的VASi为63.8±17.1%。无严重并发症。
结论
我们的数据表明，除上颈椎疾病外或独立于上颈椎疾病，下颈椎疾病在头痛的发生中也可能起作用。
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