Systematic Review of Radiofrequency Ablation and Pulsed Radiofrequency for Management of Cervicogenic Headaches
Purpose of Review
Cervicogenic headache (CHA) is a secondary headache which has a source in the upper cervical spine. Many traditional analgesic choices lack good efficacy in managing the associated pain. As a result, in management of CHA, radiofrequency ablation (RFA) or pulse radiofrequency (PRF) has been tried with success. Our study investigated the use of RFA and PRF for the management of CHA.
In the present investigation, a review of the literature was conducted using PubMed (1966 to February 2017). The quality assessment was determined using The Cochrane Risk of Bias. After initial search and consultation with experts, 34 articles were identified for initial review and 10 articles met inclusion for review. Criteria for inclusion were primarily based on identification of articles discussing cervicogenic headaches which were previously treatment resistant and occurred without any other pathology of the craniofacial region or inciting event such as trauma.
This systematic review demonstrated that RFA and PRFA provide very limited benefit in the management of CHA. At present, there is no high-quality RCT and/or strong non-RCTs to support the use of these techniques, despite numerous case reports which have demonstrated benefit. This review is one of the first to provide a comprehensive overview of the use of RFA and PRF in the management of CHA.
KeywordsChronic pain Cervicogenic headache Radiofrequency ablation Pulsed radiofrequency ablation
Compliance with Ethical Standards
Conflict of Interest
Ravi K. Grandhi and Alaa Abd-Elsayed declare that they have no conflict of interest. Alan D. Kaye is a speaker for Depomed, Inc. and Merck, Inc.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 27.• Halim W, Chua NH, Vissers KC. Long-term pain relief in patients with cervicogenic headaches after pulsed radiofrequency application into the lateral atlantoaxial (C1-2) joint using an anterolateral approach. Pain Pract. 2010;10(4):267–71. This is important as this is the most recent and relevant reference discussing this topic.CrossRefPubMedGoogle Scholar
- 28.• Gabrhelik T, Michalek P, Adamus M. Pulsed radiofrequency therapy versus greater occipital nerve block in the management of refractory cervicogenic headache—a pilot study. Prague Med Rep. 2011;112(4):279–87. This is important as this is the most recent and relevant reference discussing this topic.PubMedGoogle Scholar
- 29.• Park SW, Park YS, Nam TK, Cho TG. The effect of radiofrequency neurotomy of lower cervical medial branches on cervicogenic headache. J Korean Neurosurg Soc. 2011;50(6):507–11. This is important as this is the most recent and relevant reference discussing this topic.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.• Hamer J, Purath T. Response of cervicogenic headaches and occipital neuralgia to radiofrequency ablation of the C2 dorsal root ganglion and/or third occipital nerve. Headache. 2014;54:500–10. This is important as this is the most recent and relevant reference discussing this topic.CrossRefPubMedGoogle Scholar