Chung Moonyoung, Lee Won Hee
Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Bucheon, Korea.
Department of Neurosurgery, Inje University Busan Paik Hospital, Busan, Korea.
J Korean Neurosurg Soc. 2025 Jan;68(1):37-45. doi: 10.3340/jkns.2024.0004. Epub 2024 Jun 20.
This study aimed to evaluate the clinical effects of medial branch blocks (MBBs) C2 and C3 in treating patients with medically intractable headaches.
The medical records of 81 patients with medically intractable headaches who underwent a C2/3 MBB between January 2019 and March 2022 were retrospectively reviewed. The degrees of pain were evaluated using a Visual analogue scale (VAS) score (rating 0-10) on baseline and after procedures. To evaluate patients' satisfaction for the treatment, self-reporting measurements were examined and were categorized as excellent (>90% pain relief), good (50-90% pain relief), fair (10-50% pain relief), and none (<10% pain relief).
The total number of MBB procedure was 107. The average baseline VAS score was 7.4±1.5, which improved significantly to 2.6±2.3, 3.6±2.6, and 4.5±3.2 on 1-3 days, 3-7 days, and 3 months after the procedure, respectively (Wilks' lambda within group test, p<0.001). For the subjective feeling of pain relief, percentages of "excellent" response in the self-reporting measurements were significantly decreased over time (chi-square test; p=0.001).
This study demonstrates clinical effectiveness of C2/3 MBB in patients with medically intractable headaches, with both early and prolonged benefits.
本研究旨在评估C2和C3内侧支阻滞(MBB)治疗药物难治性头痛患者的临床效果。
回顾性分析2019年1月至2022年3月期间接受C2/3 MBB治疗的81例药物难治性头痛患者的病历。在基线和治疗后使用视觉模拟量表(VAS)评分(0-10分)评估疼痛程度。为评估患者对治疗的满意度,检查了自我报告测量结果,并将其分类为优秀(疼痛缓解>90%)、良好(疼痛缓解50-90%)、中等(疼痛缓解10-50%)和无缓解(疼痛缓解<10%)。
MBB治疗的总次数为107次。平均基线VAS评分为7.4±1.5,在治疗后1-3天、3-7天和3个月时分别显著改善至2.6±2.3、3.6±2.6和4.5±3.2(组内威尔克斯检验,p<0.001)。对于疼痛缓解的主观感受,自我报告测量中“优秀”反应的百分比随时间显著降低(卡方检验;p=0.001)。
本研究证明了C2/3 MBB对药物难治性头痛患者的临床有效性,具有早期和长期益处。