Choi Hyuk Jai, Oh In Ho, Choi Seok Keun, Lim Young Jin
Department of Neurosurgery, School of Medicine, Kyung Hee University, Seoul, Korea.
J Korean Neurosurg Soc. 2012 May;51(5):281-5. doi: 10.3340/jkns.2012.51.5.281. Epub 2012 May 31.
Occipital neuralgia is characterized by paroxysmal jabbing pain in the dermatomes of the greater or lesser occipital nerves caused by irritation of these nerves. Although several therapies have been reported, they have only temporary therapeutic effects. We report the results of pulsed radiofrequency treatment of the occipital nerve, which was used to treat occipital neuralgia.
Patients were diagnosed with occipital neuralgia according to the International Classification of Headache Disorders classification criteria. We performed pulsed radiofrequency neuromodulation when patients presented with clinical findings suggestive occipital neuralgia with positive diagnostic block of the occipital nerves with local anesthetics. Patients were analyzed according to age, duration of symptoms, surgical results, complications and recurrence. Pain was measured every month after the procedure using the visual analog and total pain indexes.
From 2010, ten patients were included in the study. The mean age was 52 years (34-70 years). The mean follow-up period was 7.5 months (6-10 months). Mean Visual Analog Scale and mean total pain index scores declined by 6.1 units and 192.1 units, respectively, during the follow-up period. No complications were reported.
Pulsed radiofrequency neuromodulation of the occipital nerve is an effective treatment for occipital neuralgia. Further controlled prospective studies are necessary to evaluate the exact effects and long-term outcomes of this treatment method.
枕神经痛的特征是枕大神经或枕小神经的皮节出现阵发性刺痛,由这些神经受到刺激所致。尽管已有多种治疗方法的报道,但它们都只有暂时的治疗效果。我们报告了用于治疗枕神经痛的枕神经脉冲射频治疗结果。
根据国际头痛疾病分类标准对患者进行枕神经痛诊断。当患者出现提示枕神经痛的临床症状且枕神经局部麻醉诊断性阻滞阳性时,我们进行脉冲射频神经调节。根据年龄、症状持续时间、手术结果、并发症和复发情况对患者进行分析。术后每月使用视觉模拟评分和总疼痛指数测量疼痛程度。
自2010年起,10例患者纳入本研究。平均年龄为52岁(34 - 70岁)。平均随访期为7.5个月(6 - 10个月)。随访期间,平均视觉模拟评分和平均总疼痛指数评分分别下降了6.1个单位和192.1个单位。未报告并发症。
枕神经脉冲射频神经调节是治疗枕神经痛的有效方法。需要进一步进行对照前瞻性研究以评估该治疗方法的确切效果和长期疗效。