Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Anesthesiology Department, Louisiana State University School of Medicine, New Orleans, LA, USA.
Curr Pain Headache Rep. 2018 Feb 23;22(3):18. doi: 10.1007/s11916-018-0673-9.
Cervicogenic headache (CHA) is a secondary headache which has a source in the upper cervical spine. Many traditional analgesic choices lack good efficacy in managing the associated pain. As a result, in management of CHA, radiofrequency ablation (RFA) or pulse radiofrequency (PRF) has been tried with success. Our study investigated the use of RFA and PRF for the management of CHA.
In the present investigation, a review of the literature was conducted using PubMed (1966 to February 2017). The quality assessment was determined using The Cochrane Risk of Bias. After initial search and consultation with experts, 34 articles were identified for initial review and 10 articles met inclusion for review. Criteria for inclusion were primarily based on identification of articles discussing cervicogenic headaches which were previously treatment resistant and occurred without any other pathology of the craniofacial region or inciting event such as trauma. This systematic review demonstrated that RFA and PRFA provide very limited benefit in the management of CHA. At present, there is no high-quality RCT and/or strong non-RCTs to support the use of these techniques, despite numerous case reports which have demonstrated benefit. This review is one of the first to provide a comprehensive overview of the use of RFA and PRF in the management of CHA.
颈源性头痛（CHA）是一种继发性头痛，其病因在上颈段。许多传统的镇痛选择在管理相关疼痛方面效果不佳。因此，在 CHA 的治疗中，射频消融（RFA）或脉冲射频（PRF）已被成功尝试。我们的研究调查了 RFA 和 PRF 用于 CHA 治疗的效果。
在本研究中，我们使用 PubMed（1966 年至 2017 年 2 月）进行了文献回顾。使用 The Cochrane 风险偏倚评估进行了质量评估。经过初步搜索和专家咨询，确定了 34 篇文章进行初步审查，其中 10 篇文章符合纳入标准。纳入标准主要基于确定先前对治疗有抵抗性且无颅面区域或诱发事件（如创伤）的其他病理变化的颈源性头痛的文章。这项系统评价表明，RFA 和 PRFA 在 CHA 的治疗中仅提供非常有限的益处。目前，尽管有许多病例报告表明这些技术有效，但缺乏高质量的 RCT 和/或强有力的非 RCT 来支持这些技术的应用。这是第一篇对 RFA 和 PRF 在 CHA 治疗中的应用进行全面概述的综述之一。
