颈2背根神经节射频治疗颈源性头痛疗效及影响因素分析

EFFICACY AND INFLUENCING FACTORS OF RADIOFREQUENCY TREATMENT OF CERVICOGENIC HEADACHE IN C2 DORSAL ROOT GANGLION

摘要:

研究颈2背根神经节脉冲射频（pulsed radiofrequency ,PRF）治疗颈源性头痛（cervicogenic headache, CEH）的疗效，并分析影响疗效的因素。方法：回顾性分析60例行颈2背根神经节PRF治疗CEH患者的一般资料，术前及术后3天、1周、1月、3月、6月的视觉疼痛模拟量表（visual analogue scale, VAS）评分，匹茨堡睡眠质量指数量表（Pittsburgh sleep quality index, PSQI）评分，颈椎活动度（range of motion, ROM）评分，焦虑自评量表（self-rating anxiety scale, SAS）评分，采用重复测量方差分析评估疼痛变化情况，根据术后6月患者改良MacNab评分将患者分为E组（优效组）与P组（差效组），采用Logistic回归分析评价影响预后的相关因素。结果：患者术后疼痛评分较术前均明显下降，术后1周ROM较术后3天升高，术后6月PSQI、VAS、ROM较术后3月升高，CEH患者术前ROM、SAS高、病程长、双侧头痛是预后不良的危险因素。结论：CEH 患者行颈2背根神经节PRF术在短期内可取得良好疗效，术前ROM、SAS高，病程长，双侧CEH影响治疗效果。

Abstract:

To study the efficacy of pulsed radiofrequency (PRF) in the treatment of cervicogenic headache (CEH) and to analyze the influencing factors. Methods: The general data of 60 patients with CEH treated with PRF were retrospective analysised. The visual analogue scale (VAS), Pittsburgh sleep quality index (PSQI) ,range of motion (ROM) and self-rating anxiety scale（SAS）were evaluated at before and 3 days, 1 week, 1 month, 3 months and 6 months after PRF, According to the modified MacNab score, the patients were divided into group E (excellent group) and group P (poor group). Logistic regression analysis was used to evaluate the prognostic factors. Results: The postoperative pain indexes were significantly decreased compared with those before operation. ROM at 1 week after operation was higher than that in 3 days after operation. PSQI, VAS and ROM in 6 months after operation were higher than those in 3 months after operation. High ROM, SAS, long course of disease and bilateral headache were risk factors for poor prognosis in CEH patients. Conclusion: PRF of C2 dorsal root ganglion in patients with CEH can achieve good curative effect in a short time.The therapeutic effect will be affected with high ROM and SAS before operation, long course of disease and bilateral CEH.