Randomised controlled trial of cervical radiofrequency lesions as a treatment for cervicogenic headache [ISRCTN07444684]

被引:51
作者
Haspeslagh S.R.S. [1 ]
Van Suijlekom H.A. [1 ]
Lamé I.E. [1 ]
Kessels A.G.H. [1 ]
van Kleef M. [1 ]
Weber W.E.J. [1 ]
机构
[1] Dept. of Anesthesiology, University Hospital Maastricht, Maastricht
关键词
Visual Analogue Scale; Dorsal Root Ganglion; Transcutaneous Electrical Nerve Stimulation; Cervicogenic Headache; Great Occipital Nerve;
D O I
10.1186/1471-2253-6-1
中图分类号
学科分类号
摘要
Background: Cervicogenic headache (CEH) is a unilateral headache localised in the neck or occipital region, projecting to the frontal and temporal regions. Since the pathogenesis of this syndrome appears to have an anatomical basis in the cervical region, several surgical procedures aimed at reducing the nociceptive input on the cervical level, have been tested. We developed a sequence of various cervical radiofrequency neurotomies (facet joint denervations eventually followed by upper dorsal root ganglion neurotomies) that proved successful in a prospective pilot trial with 15 CEH patients. To further evaluate this sequential treatment program we conducted a randomised controlled trial Methods: 30 patients with cervicogenic headache according to the Sjaast ad diagnostic criteria, were randomised. 15 patients received a sequence of radiofrequency treatments (cervical facet joint denervation, followed by cervical dorsal root ganglion lesions when necessary), and the other 15 patients underwent local injections with steroid and anaesthetic at the greater occipital nerve, followed by transcutaneous electrical nerve stimulation (TENS) when necessary. Visual analogue scores for pain, global perceived effects scores, quality of life scores were assessed at 8, 16, 24 and 48 weeks. Patients also kept a headache diary. Results: There were no statistically significant differences between the two treatment groups at any time point in the trial. Conclusion: We did not find evidence that radiofrequency treatment of cervical facet joints and upper dorsal root ganglions is a better treatment than the infiltration of the greater occipital nerve, followed by TENS for patients fulfilling the clinical criteria of cervicogenic headache. © 2006 Haspeslagh et al; licensee BioMed Central Ltd.
引用
收藏
页数:11
相关论文
共 47 条
[1]  
Barre M., Sur un syndrome sympathique cervicale posterieur et sa cause frequente: Lárthritide cervicale, Rev Neurol, 33, pp. 1246-1248, (1926)
[2]  
Sjaastad O., Saunte C., Hovdahl H., Breivik H., Gronbaek E., Cervicogenic" Headache. An hypothesis, Cephalalgia, 3, 4, pp. 249-256, (1983)
[3]  
Fredriksen T.A., Hovdal H., Sjaastad O., Cervicogenic headache" Clinical manifestation, Cephalaigia, 7, 2, pp. 147-160, (1987)
[4]  
Sjaastad O., Fredriksen T.A., Pfaffenrath V., Cervicogenic headache: Diagnostic criteria, Headache, 30, 11, pp. 725-726, (1990)
[5]  
Sjaastad O., Frederiksen T.A., Chronic daily headache: Is "cervicogenic headache" one subgroup?, Cephalaigia, 18, SUPPL. 21, pp. 37-40, (1998)
[6]  
Sjaastad O., Fredriksen T.A., Cervicogenic headache: Criteria, classification and epidemiology, Clin Exp Rheumatol, 18, 2 SUPPL. 19, (2000)
[7]  
Leone M., D'Amico D., Grazzi L., Attanasio A., Bussone G., Cervicogenic headache: A critical review of the current diagnostic criteria, Pain, 78, 1, pp. 1-5, (1998)
[8]  
van Suijlekom J.A., de Vet H.C., van den Berg S.G., Weber W.E., Interobserver reliability of diagnostic criteria for cervicogenic headache, Cephalaigia, 19, 9, pp. 817-823, (1999)
[9]  
Pereira Montero J.M., Barros J., Correia A.P., Pinheiro J., Maio R.J.M.C., The prevalence of cervicogenic headache in an urban population of Porto, Funct Neurol, 11 A, (1996)
[10]  
Nilsson N., Bove G., Evidence that tension-type headache and cervicogenic headache are distinct disorders, J Manipulative Physiol Ther, 23, 4, pp. 288-289, (2000)