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. 2006 Feb 16:6:1.
doi: 10.1186/1471-2253-6-1.

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

Sara R S Haspeslagh  1 , Hans A Van Suijlekom, Inge E Lamé, Alfons G H Kessels, Maarten van Kleef, Wim E J Weber
Affiliations

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

Sara R S Haspeslagh et al. BMC Anesthesiol. .

Abstract

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 Sjaastad 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.

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Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Comparison of mean health domains at different follow-up measurements for both groups (I = Radiofrequency Group and II = Local injection group).
See this image and copyright information in PMC

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