Spinal Care Unit, Sapir Medical Center, Kfar-Saba, Sharon Region, Israel.
J Neurosurg Anesthesiol. 2013 Jul;25(3):340-3. doi: 10.1097/ANA.0b013e3182905e89.
Chronic shoulder or suprascapular pain is a disabling phenomenon. Chronic headache is also a disabling phenomenon for many patients. Once it was believed that chronic headache that is attributed to the cervical spine originates from the upper cervical nerve roots (C0-C3). Currently, it is suggested by some authors that the reason for headache in many patients is attributed to the lower cervical nerve roots in the cervical spine. The suprascapular nerve originates from the C5 and C6 nerve roots and supplies the suprascapular and shoulder region. Pulsed radiofrequency (PRF) has gained popularity over recent years as a good clinical tool in treating patients with shoulder/suprascapular pain. It is usually considered as a treatment option after conservative treatment has failed. The purpose of this study was to evaluate whether PRF for the suprascapular nerve has also beneficial effect for patients that have also chronic headache that is attributed to the lower cervical nerve roots.
Sixty-nine patients with a follow-up of 1 year who had chronic shoulder/suprascapular pain and chronic headache were examined after they underwent PRF procedures to the suprascapular nerve (either unilateral or bilateral).
Forty patients (58%) reported long-term pain relief (1-y follow-up) for the shoulder/suprascapular pain and 31 patients (45%) reported long-term pain relief for the headache. This pain relief was defined as reduction of Visual Analogue Score by at least 30%. No complications were found in this study except for mild discomfort in the treated area which spontaneously resolved up to 3 weeks after the procedure.
PRF for the suprascapular nerve is a safe and an effective procedure for patients who suffer from shoulder/suprascapular pain and also for headache that is attributed to the lower cervical nerve roots. It should be tried after conservative treatment has failed.
慢性肩部或肩胛上疼痛是一种致残现象。慢性头痛也是许多患者致残的现象。曾经，人们认为归因于颈椎的慢性头痛起源于颈上神经根（C0-C3）。目前，一些作者认为，许多患者头痛的原因是归因于颈椎的颈下神经根。肩胛上神经起源于 C5 和 C6 神经根，供应肩胛上区和肩部。脉冲射频（PRF）近年来作为一种治疗肩部/肩胛上疼痛患者的良好临床工具而广受欢迎。它通常被认为是保守治疗失败后的一种治疗选择。本研究旨在评估肩胛上神经 PRF 是否对归因于颈下神经根的慢性头痛患者也有有益的效果。
69 例慢性肩部/肩胛上疼痛和慢性头痛患者，在接受肩胛上神经 PRF 治疗（单侧或双侧）后进行了为期 1 年的随访。
40 例（58%）患者肩部/肩胛上疼痛长期缓解（1 年随访），31 例（45%）患者头痛长期缓解。这种疼痛缓解定义为视觉模拟评分至少降低 30%。本研究未发现并发症，除治疗区域轻度不适外，该不适会在治疗后 3 周内自发缓解。
肩胛上神经 PRF 是一种安全有效的治疗肩部/肩胛上疼痛和归因于颈下神经根的头痛患者的方法。应在保守治疗失败后尝试。
