DOI QR코드

DOI QR Code

The Effect of Radiofrequency Neurotomy of Lower Cervical Medial Branches on Cervicogenic Headache

  • Park, Seung-Won (Department of Neurosurgery, Spine Center, Chung-Ang University Hospital, Chung-Ang University School of Medicine) ;
  • Park, Yong-Sook (Department of Neurosurgery, Spine Center, Chung-Ang University Hospital, Chung-Ang University School of Medicine) ;
  • Nam, Taek-Kyun (Department of Neurosurgery, Spine Center, Chung-Ang University Hospital, Chung-Ang University School of Medicine) ;
  • Cho, Tack-Geun (Department of Neurosurgery, Hallym University College of Medicine)
  • Received : 2011.05.11
  • Accepted : 2011.12.19
  • Published : 2011.12.28

Abstract

Objective : Cervicogenic headache (CGH) is known to be mainly related with upper cervical problems. In this study, the effect of radiofrequency neurotomy (RFN) for lower cervical (C4-7) medial branches on CGH was evaluated. Methods : Eleven patients with neck pain and headache, who were treated with lower cervical RFN due to supposed lower cervical zygapophysial joint pain without symptomatic intervertebral disc problem or stenosis, were enrolled in this study. CGH was diagnosed according to the diagnostic criteria of the cervicogenic headache international study group. Visual analogue scale (VAS) score and degree of VAS improvement (VASi) (%) were checked for evaluation of the effect of lower cervical RFN on CGH. Results : The VAS score at 6 months after RFN was $2.7{\pm}1.3$, which were significantly decreased comparing to the VAS score before RFN, $8.1{\pm}1.1$ ($p$<0.001). The VASi at 6 months after RFN was $63.8{\pm}17.1%$. There was no serious complication. Conclusion : Our data suggest that lower cervical disorders can play a role in the genesis of headache in addition to the upper cervical disorders or independently.

Keywords

References

  1. Anthony M : Cervicogenic headache : prevalence and response to local steroid therapy. Clin Exp Rheumatol 18 : S59-S64, 2000
  2. Antonaci F, Bono G, Mauri M, Drottning M, Buscone S : Concepts leading to the definition of the term cervicogenic headache : a historical overview. J Headache Pain 6 : 462-466, 2005 https://doi.org/10.1007/s10194-005-0250-6
  3. Balla JI : The late whiplash syndrome. Aust N Z J Surg 50 : 610-614, 1980 https://doi.org/10.1111/j.1445-2197.1980.tb04207.x
  4. Bansevicius D, Pareja JA : The "skin roll" test : a diagnostic test for cervicogenic headache? Funct Neurol 13 : 125-133, 1998
  5. Barnsley L, Lord S, Bogduk N : Comparative local anaesthetic blocks in the diagnosis of cervical zygapophysial joint pain. Pain 55 : 99-106, 1993 https://doi.org/10.1016/0304-3959(93)90189-V
  6. Blume HG : Cervicogenic headaches : radiofrequency neurotomy and the cervical disc and fusion. Clin Exp Rheumatol 18 : S53-S58, 2000
  7. Blume HG : Treatment of cervicogenic headaches : radiofrequency neurotomy to the sinuvertebral nerves to the upper cervical disc and to the outer layer of the C3 nerve root or C4 nerve root respectively. Funct Neurol 13 : 83-84, 1998
  8. Bogduk N : Cervicogenic headache : anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep 5 : 382-386, 2001 https://doi.org/10.1007/s11916-001-0029-7
  9. Bogduk N, Marsland A : On the concept of third occipital headache. J Neurol Neurosurg Psychiatry 49 : 775-780, 1986 https://doi.org/10.1136/jnnp.49.7.775
  10. Bono G, Antonaci F, Dario A, Clerici AM, Ghirmai S, Nappi G : Unilateral headaches and their relationship with cervicogenic headache. Clin Exp Rheumatol 18 : S11-S15, 2000
  11. Bovim G, Berg R, Dale LG : Cervicogenic headache : anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/C3). Pain 49 : 315-320, 1992 https://doi.org/10.1016/0304-3959(92)90237-6
  12. Chouret EE : The greater occipital neuralgia headache. Headache 7 : 33-34, 1967 https://doi.org/10.1111/j.1526-4610.1967.hed0701033.x
  13. D'Amico D, Leone M, Bussone G : Side-locked unilaterality and pain localization in long-lasting headaches : migraine, tension-type headache, and cervicogenic headache. Headache 34 : 526-530, 1994 https://doi.org/10.1111/j.1526-4610.1994.hed3409526.x
  14. De Araujo Lucas G, Laudanna A, Chopard RP, Raffaelli E Jr : Anatomy of the lesser occipital nerve in relation to cervicogenic headache. Clin Anat 7 : 90-96, 1994 https://doi.org/10.1002/ca.980070207
  15. Diener HC, Kaminski M, Stappert G, Stolke D, Schoch B : Lower cervical disc prolapse may cause cervicogenic headache : prospective study in patients undergoing surgery. Cephalalgia 27 : 1050-1054, 2007 https://doi.org/10.1111/j.1468-2982.2007.01385.x
  16. Drottning M, Staff PH, Sjaastad O : Cervicogenic headache after whiplash injury. Cephalalgia 17 : 288-289, 1997
  17. Edmeads J : The cervical spine and headache. Neurology 38 : 1874-1878, 1988 https://doi.org/10.1212/WNL.38.12.1874
  18. Farina S, Granella F, Malferrari G, Manzoni GC : Headache and cervical spine disorders : classification and treatment with transcutaneous electrical nerve stimulation. Headache 26 : 431-433, 1986 https://doi.org/10.1111/j.1526-4610.1986.hed2608431.x
  19. Feng FL, Schofferman J : Chronic Neck Pain and Cervicogenic Headaches. Curr Treat Options Neurol 5 : 493-498, 2003 https://doi.org/10.1007/s11940-996-0017-7
  20. Fredriksen TA, Fougner R, Tangerud A, Sjaastad O : Cervicogenic headache. Radiological investigations concerning head/neck. Cephalalgia 9 : 139-146, 1989
  21. Freund BJ, Schwartz M : Treatment of chronic cervical-associated headache with botulinum toxin A : a pilot study. Headache 40 : 231-236, 2000 https://doi.org/10.1046/j.1526-4610.2000.00033.x
  22. Gille O, Lavignolle B, Vital JM : Surgical treatment of greater occipital neuralgia by neurolysis of the greater occipital nerve and sectioning of the inferior oblique muscle. Spine (Phila Pa 1976) 29 : 828-832, 2004 https://doi.org/10.1097/01.BRS.0000112069.37836.2E
  23. Grillo F : The differential diagnosis and therapy of headache. Swiss Ann Chiroprac 2 : 121-166, 1961
  24. Grillo F : The differential diagnosis and therapy of headache. Swiss Ann Chiroprac 2 : 121-166, 1961
  25. Haldeman S, Dagenais S : Cervicogenic headache : a critical review. Spine J 1 : 31-46, 2001
  26. Haspeslagh SR, Van Suijlekom HA, Lamé IE, Kessels AG, van Kleef M, Weber WE : Randomised controlled trial of cervical radiofrequency lesions as a treatment for cervicogenic headache [ISRCTN07444684]. BMC Anesthesiol 6 : 1, 2006 https://doi.org/10.1186/1471-2253-6-1
  27. Headache Classification Subcommittee of the International Headache Society : The International Classification of Headache Disorders : 2nd edition. Cephalalgia 24 Suppl 1 : 9-160, 2004
  28. Hinderaker J, Lord SM, Barnsley L, Bogduk N : Diagnostic value of C2-3 instantaneous axes of rotation in patients with headache of cervical origin. Cephalalgia 15 : 391-395, 1995
  29. Jansen J, Bardosi A, Hildebrandt J, Lücke A : Cervicogenic, hemicranial attacks associated with vascular irritation or compression of the cervical nerve root C2. Clinical manifestations and morphological findings. Pain 39 : 203-212, 1989 https://doi.org/10.1016/0304-3959(89)90007-9
  30. Jull G, Barrett C, Magee R, Ho P : Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 19 : 179-185, 1999 https://doi.org/10.1046/j.1468-2982.1999.1903179.x
  31. Kim JS, Roh JK, Ahn YO : Epidemiological and clinical characteristics of tension-type headache in Korea. J Korean Neurol Assoc 15 : 615-623, 1997
  32. Leone M, D'Amico D, Grazzi L, Attanasio A, Bussone G : Cervicogenic headache : a critical review of the current diagnostic criteria. Pain 78 : 1-5, 1998 https://doi.org/10.1016/S0304-3959(98)00116-X
  33. Lord SM, Barnsley L, Wallis BJ, McDonald GJ, Bogduk N : Percutaneous radio-frequency neurotomy for chronic cervical zygapophyseal-joint pain. N Engl J Med 335 : 1721-1726, 1996 https://doi.org/10.1056/NEJM199612053352302
  34. Macnab I : Chapter 14. Pain and disability in degenerative disc disease. Clin Neurosurg 20 : 193-196, 1973
  35. Maimaris C, Barnes MR, Allen MJ : 'Whiplash injuries' of the neck : a retrospective study. Injury 19 : 393-396, 1988 https://doi.org/10.1016/0020-1383(88)90131-3
  36. Michler RP, Bovim G, Sjaastad O : Disorders in the lower cervical spine. A cause of unilateral headache? A case report. Headache 31 : 550-551, 1991 https://doi.org/10.1111/j.1526-4610.1991.hed3108550.x
  37. Nilsson N : The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine (Phila Pa 1976) 20 : 1884-1888, 1995 https://doi.org/10.1097/00007632-199509000-00008
  38. Park CH, Jeon EY, Chung JY, Kim BI, Roh WS, Cho SK : Application of pulsed radiofrequency for 3rd occipital neuralgia : a case report. J Korean Pain Soc 17 : 63-65, 2004 https://doi.org/10.3344/jkps.2004.17.1.63
  39. Pollmann W, Keidel M, Pfaffenrath V : Headache and the cervical spine : a critical review. Cephalalgia 17 : 801-816, 1997 https://doi.org/10.1046/j.1468-2982.1997.1708801.x
  40. Sjaastad O, Fredriksen TA : Cervicogenic headache : criteria, classification and epidemiology. Clin Exp Rheumatol 18 : S3-S6, 2000 https://doi.org/10.1007/s100510070070
  41. Sjaastad O, Fredriksen TA, Pfaffenrath V : Cervicogenic headache : diagnostic criteria. The Cervicogenic Headache International Study Group. Headache 38 : 442-445, 1998 https://doi.org/10.1046/j.1526-4610.1998.3806442.x
  42. Sjaastad O, Saunte C, Hovdahl H, Breivik H, Grønbaek E : "Cervicogenic" headache. An hypothesis. Cephalalgia 3 : 249-256, 1983 https://doi.org/10.1046/j.1468-2982.1983.0304249.x
  43. van Suijlekom HA, van Kleef M, Barendse GA, Sluijter ME, Sjaastad O, Weber WE : Radiofrequency cervical zygapophyseal joint neurotomy for cervicogenic headache : a prospective study of 15 patients. Funct Neurol 13 : 297-303, 1998
  44. Vincent MB, Luna RA : Cervicogenic headache : a comparison with migraine and tension-type headache. Cephalalgia 19 Suppl 25 : 11-16, 1999

Cited by

  1. Update on the Role of Z-Joint Injection and Radiofrequency Neurotomy for Cervicogenic Headache vol.5, pp.3, 2013, https://doi.org/10.1016/j.pmrj.2013.01.001
  2. Concussion: Purely a Brain Injury? vol.23, pp.5, 2011, https://doi.org/10.1097/jsm.0b013e318295bbb1
  3. Unusual Clinical Presentations of Cervical or Lumbar Dorsal Ramus Syndrome vol.11, pp.2, 2011, https://doi.org/10.14245/kjs.2014.11.2.57
  4. Systematic Review of Radiofrequency Ablation and Pulsed Radiofrequency for Management of Cervicogenic Headaches vol.22, pp.3, 2011, https://doi.org/10.1007/s11916-018-0673-9
  5. Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management vol.19, pp.5, 2019, https://doi.org/10.1007/s11910-019-0937-8
  6. Diagnostic Value of Single-Photon Emission Computed Tomography/Computed Tomography Scans with Tc-99m HDP in Cervicogenic Headache vol.9, pp.2, 2011, https://doi.org/10.3390/jcm9020399
  7. The Effectiveness of Cervical Medial Branch Thermal Radiofrequency Neurotomy Stratified by Selection Criteria: A Systematic Review of the Literature vol.21, pp.11, 2011, https://doi.org/10.1093/pm/pnaa219