Efficacy of interventional treatment strategies for managing patients with cervicogenic headache: a systematic review

Goyal, Sonal; Kumar, Ajit; Mishra, Pravas; Goyal, Divakar

doi:10.4097/kja.21328

Cited by 5 publications

(6 citation statements)

References 38 publications

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“…Studies have demonstrated the effectiveness of RFA in treating some pain conditions [9,13]. It is believed that interrupting these nerves' normal activity for a small period of time with an anesthetic block or a semi-permanent period with RF lesioning causes Wallerian degeneration of the afferent nerve fibers, which frequently reduces this referred pain [5,12,13]. However, according to this study and others, pain alleviation is typically just transient and only lasts till the time of nerve regeneration or healing.…”

Section: Introductionmentioning

confidence: 55%

“…Radiofrequency (RF) ablative treatments have been widely accepted in specialties like oncology, cardiology, and chronic pain. Studies have demonstrated the effectiveness of RFA in treating some pain conditions [9,13]. It is believed that interrupting these nerves' normal activity for a small period of time with an anesthetic block or a semi-permanent period with RF lesioning causes Wallerian degeneration of the afferent nerve fibers, which frequently reduces this referred pain [5,12,13].…”

Section: Introductionmentioning

confidence: 99%

“…However, according to this study and others, pain alleviation is typically just transient and only lasts till the time of nerve regeneration or healing. While RFA alleviates the crippling pain, it does not address the headache's underlying causes, which are frequently never fully determined [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Radiofrequency Ablation and Epidural Steroid Injection for Management of Cervicogenic Headaches and Neck Pain: Meta-Analysis and Literature Review

Ekhator¹,

Urbi²,

Nduma³

et al. 2023

Cureus

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Dysfunction of the cervical spine and its anatomical features, mostly innervated by the C1, C2, and C3 spinal nerves, can result in a secondary headache known as cervicogenic headache (CHA), mainly characterized by unilateral pain. The usefulness of pharmaceutical medications and physical therapy is currently the subject of scant literature. Interventional pain management techniques can be applied when conservative treatment is unsuccessful. This study looks at radiofrequency ablation (RFA) and epidural steroid injection (ESI) to identify their safety and efficacy in managing patients with cervicogenic headaches and neck pain. Three databases -PubMed, Cochrane CENTRAL Library, and Embase were searched, and 110 studies were identified. Nine screening processes were included for review and meta-analysis. Statistical evaluation was conducted through STATA version 17 (College Station, TX: StataCorp LLC) and effect measures were reported through random effects model risk ratios. The main subject of focus included three following outcomes: incidences of pain relief, degree and duration of pain, and incidences of adverse effects. The findings showed both interventions relieved pain by a factor of >50%, demonstrating a relative effects risk

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Section: Introductionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Radiofrequency Ablation and Epidural Steroid Injection for Management of Cervicogenic Headaches and Neck Pain: Meta-Analysis and Literature Review

Ekhator¹,

Urbi²,

Nduma³

et al. 2023

Cureus

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“…There are limited review articles discussing the adverse effects and adverse outcomes of cryoneurolysis for pain. The incidence of such events was noted to be low and self-resolving 20,21 …”

Section: Discussionmentioning

confidence: 99%

Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Winston¹,

MacRae

Rajapakshe³

et al. 2023

Am J Phys Med Rehabil

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Objective The aim of the study is to report adverse effects from clinical studies on ultrasound-guided percutaneous cryoneurolysis for spasticity. Design Patients were prospectively enrolled in three studies at a single institution. Cryoneurolysis was performed to primarily motor nerve branches (medial and lateral pectoral, musculocutaneous, radial, median, ulnar, tibial, obturator) and mixed motor sensory nerve trunks (median, ulnar, suprascapular, radial, and tibial). Results Cryoneurolysis was performed for 277 nerves (99 mixed motor sensory), on 113 patients (59 F, 54 M, average age 54.4 yrs). One patient had a local skin infection and two patients had bruising or swelling; all resolved within 1 mo. Nine reported nerve pain or dysesthesia (two motor, seven mixed motor sensory nerves). Four received no treatment, four oral or topical medications, two perineural injections, one botulinum toxin. Three patients’ symptoms remained until 3 mos and one had numbness at six. One patient had botulinum toxin injections for cramping. All had at minimum 3-mo follow-up; seven withdrew (x̄ = 5.4 mos), four passed away. None of these 11 reported adverse effects. Conclusions A total of 96.75% of nerve treatments had no pain or dysesthesias beyond treatment. Few had pain or numbness beyond 3 mos. Cryoneurolysis has potential to be a safe spasticity treatment with manageable adverse effects.

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“…First, several different methods for assessing CCS, such as cervical spinal-canal area, cervical dural-sac area, lateral mass, morphologic grading, and cervical ligamentum flavum hypertrophy, have been proved to be effective at diagnosing CCS. [21][22][23][24][25][26][27] However, we analyzed only the measurement of CPT.…”

Section: Discussionmentioning

confidence: 99%

Best cutoff score of cervical-pedicle thickness as a morphological parameter for predicting cervical central stenosis

et al. 2022

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There are various factors for the cause of cervical central stenosis (CCS), such as osteophyte, cervical-disc degeneration, and cervical ligamentum flavum hypertrophy. However, the pedicle of the cervical vertebra has not yet been analyzed for its relationship with CCS. We created a new morphologic parameter called the cervical-pedicle thickness (CPT) to assess the association between CCS and the cervical pedicle.We obtained morphological cases involving the CPT from 82 patients with CCS. There were also 84 in the normal group who underwent cervical spine magnetic resonance imaging (CS-MR) as part of routine health screening. We obtained the T2-weighted CS-MR axial images from group members, and assessed the CPT at the level of the C6 vertebra on CS-MR.The mean CPT was 3.46 ± 0.57 mm in the normal group, 4.97 ± 0.75 mm in the CCS group, which thus had a significantly higher CPT (P < .01) than did the normal group. For the prognostic value of the CPT as a predictor of CCS, ROC analysis indicated that the best cutoff score for the CPT was 4.18 mm, with 93.9% sensitivity, 92.9% specificity, and AUC 0.97.Greater CPT was highly associated with a possibility of CCS. This conclusion will be helpful for assessing the CCS patients.

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Efficacy of interventional treatment strategies for managing patients with cervicogenic headache: a systematic review

Abstract: This article has been accepted for publication and has undergone full peer review but has notbeen through the copyediting, typesetting, pagination, and proofreading processes, which may lead to differences between this version and the version of record.

Cited by 5 publications

References 38 publications

Safety and Efficacy of Radiofrequency Ablation and Epidural Steroid Injection for Management of Cervicogenic Headaches and Neck Pain: Meta-Analysis and Literature Review

Safety and Efficacy of Radiofrequency Ablation and Epidural Steroid Injection for Management of Cervicogenic Headaches and Neck Pain: Meta-Analysis and Literature Review

Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Best cutoff score of cervical-pedicle thickness as a morphological parameter for predicting cervical central stenosis

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