Clinical Observation Of Pulsed Radiofrequency On C2 Dorsal Root Ganglion And Greater Occipital Nerve In The Treatment Of Cervicogenic Headache

Objective:To investigate the effect of CT-guided C2 dorsal root ganglion,great-er occip ital nerve,double-target C2 dorsal root ganglion and greater occipital nerv-e in combinati on with pulsed radiofrequency procedure in the treatment of cer-vicogenic headache.Methods:A total of 60 patients with cervicogenic headache were enrolled in the study,who were treated at Pain Clinic of our hospital from February 2017 to August 2018.They were randomly divided into treatment group 1(GON),treatment group 2(C2 DRG)and treatment group 3(C2 DRG and GON),with 20 cases in each group.The VAS scores were recorded 1 day before operation,1 day after operation(24 hours),1 week after operation,and 1 month,3 months and 6 months after operation,as well as pain duration and weekly pain frequencies 1 week before operation,1 week after operation,and 1 month,3 months and 6 months after operation.The adverse reactions occurred during the operation and postoperative follow-up period were recorded.Results:1.General information:The difference in sex,mean age,body mass index(BMI)and average course of disease was not statistically significant(P>0.05)among treatment group 1,treatment group 2 and treatment group.2.VAS scores:The statistical results showed that the postoperative VAS score was significantly lower than the preoperative VAS score,and the difference was statistically significant(P<0.05)among three treatment groups.The results of comparison among groups showed that the difference in VAS score 1 day before operation,1 day after operation and 1 week after operation was not statistically significant(P>0.05).At one month after operation,the VAS score of treatment group 3 was lower than that of treatment group 1,and the difference was statistically significant(P<0.05).At three months after operation,the VAS score of treatment group 2 and treatment group 3 was lower than that of treatment group 1,and the difference was statistically significant(P<0.05).At six months after operation,there were significant differences in VAS scores among three groups,namely treatment group 3<treatment group 2<treatment group 1,and the difference was statistically significant(P<0.05).3.Weekly pain duration:The statistical results showed that the weekly postoperative pain time was significantly lower than preoperative pain time among three treatment groups,and the difference was statistically significant(P<0.05).The results of comparison among groups showed that the difference of each pain duration 1 week before operation,1 week after operation and 1 month after operation was not statistically significant(P>0.05).Each pain duration 3 months and 6 months after operation in the treatment group 2 and treatment group 3 was less than that in the treatment group 1,and the difference was statistically significant(P<0.05).While the difference was not statistically significant(P>0.05)between the treatment group 2 and treatment group 3.4.Weekly pain frequencies:The statistical results showed that the weekly postoperative pain frequencies were significantly lower than the weekly preoperative pain frequencies among three groups,and the difference was statistically significant(P<0.05).The results of comparison among groups showed that the difference of weekly pain frequencies 1 week before operation,1 week after operation and 1 month after operation was not statistically significant(P>0.05).At three months after operation,the weekly pain frequencies of treatment group 3 were less than those of treatment group 1 and treatment group 2,and the difference was statistically significant(P<0.05).At six months after operation,there were significant differences in weekly pain frequencies among three groups,namely treatment group 3<treatment group 2<treatment group 1,and the difference was statistically significant(P<0.05).Conclusion:The efficacy of both GON and C2 DRG or double targets in combination with pulsed radiofrequency is significant in the treatment of CEH.Moreover,the efficacy of GON and C2DRG double-target radiofrequency therapy is more stable.