Division of Chronic Pain Medicine, Department of Anesthesiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Pain Pract. 2024 Jan;24(1):18-24. doi: 10.1111/papr.13276. Epub 2023 Jul 17.
The purpose of this study was to retrospectively assess the efficacy of radiofrequency ablation (RFA) therapy as a treatment for occipital neuralgias and headaches at health clinics in the United States between January 1, 2015 and June 20, 2022. We hypothesize that RFA is a minimally invasive treatment that provides significant pain relief long-term for occipital neuralgias and associated headaches.
This retrospective analysis studies data collected from 277 occipital nerve RFA patients who had adequate pre-procedure and post-procedure follow-up for data analysis. Data collected includes the patient's age, biological sex, BMI, headache diagnosis, pre-procedure, and post-procedure pain score using the visual analog scale (VAS), subjective percent improvement in symptom(s), and duration of symptom relief. Statistical analysis used SPSS software, version 26 (IBM), using a paired t-test to assess the significance between pre and post-occipital RFA therapy pain scores. p-values were significant if found to be ≤0.05.
The mean pre-procedure pain score before RFA therapy for patients who completed at least 6 months of follow-up was 5.57 (SD = 1.87) and the mean post-procedure pain score after RFA therapy was 2.39 (SD = 2.42). The improvement in pain scores between pre-procedure and post-procedure was statistically significant with a p-value < 0.001. The mean patient-reported percent improvement in pain following RFA therapy was 63.53% (SD = 36.37). The mean duration of pain improvement was 253.9 days after the initiation of therapy (SD = 300.5). When excluding patients who did not have any relief following their RFA procedure, the average pre-procedure pain score was 5.54 (SD = 1.81) and post-procedure pain score was 1.71 (SD = 1.81) with a p-value < 0.001.
This study demonstrates the minimally invasive, safe, and effective treatment of RFA in patients with refractory occipital neuralgias and headaches. Additional studies are necessary to illuminate ideal patient characteristics for RFA treatment and the potential for procedural complications and long-term side effects associated with occipital nerve RFA therapy.
本研究旨在回顾性评估射频消融（RFA）治疗在美国诊所治疗枕神经痛和头痛的疗效，研究时间为 2015 年 1 月 1 日至 2022 年 6 月 20 日。我们假设 RFA 是一种微创治疗方法，可为枕神经痛和相关头痛提供长期的显著疼痛缓解。
本回顾性分析研究了 277 例接受枕神经 RFA 治疗的患者的数据，这些患者在数据分析前和数据分析后都有足够的随访。收集的数据包括患者的年龄、生物性别、BMI、头痛诊断、治疗前和治疗后的疼痛评分（使用视觉模拟量表[VAS]）、症状的主观改善百分比以及症状缓解持续时间。统计分析使用 SPSS 软件，版本 26（IBM），使用配对 t 检验评估 RFA 治疗前后枕神经痛评分的显著性。如果发现 p 值≤0.05，则认为具有统计学意义。
至少完成 6 个月随访的患者在接受 RFA 治疗前的平均疼痛评分（VAS）为 5.57（SD=1.87），接受 RFA 治疗后的平均疼痛评分（VAS）为 2.39（SD=2.42）。治疗前和治疗后的疼痛评分改善具有统计学意义，p 值<0.001。患者报告的 RFA 治疗后疼痛改善百分比的平均值为 63.53%（SD=36.37）。治疗开始后疼痛改善的平均持续时间为 253.9 天（SD=300.5）。当排除 RFA 手术后没有任何缓解的患者时，平均术前疼痛评分（VAS）为 5.54（SD=1.81），术后疼痛评分为 1.71（SD=1.81），p 值<0.001。
本研究表明，RFA 是治疗难治性枕神经痛和头痛的一种微创、安全、有效的治疗方法。需要进一步的研究来阐明 RFA 治疗的理想患者特征以及与枕神经 RFA 治疗相关的程序并发症和长期副作用的潜在风险。
