Abstract:Objective To evaluate the efficacy of combined pulsed radiofrequency (PRF) therapy targeting the C2 dorsal root ganglion and C3 medial branch of the spinal nerve with epidural catheter analgesia in the treatment of cervicogenic headache (CEH). Methods Clinical data of CEH patients treated in our department from August 2021 to July 2024 were collected. Patients who underwent PRF therapy alone (C2 dorsal root ganglion and C3 medial branch) were assigned to the control group (Group C), while those receiving additional epidural catheter analgesia were designated as the treatment group (Group T). The Numeric Rating Scale (NRS) score, headache index, cervical range of motion (ROM), Pittsburgh Sleep Quality Index (PSQI) score and Self-Rating Anxiety Scale (SAS) score were recorded preoperatively and at 3 days, 1 month, 3 months, and 6 months postoperatively. The modified MacNab scores at 6 months postoperatively and the incidence of postoperative complications were also documented. Results The PSQI scores at all postoperative time points and cervical ROM scores at 7 days and 1 month postoperatively were significantly lower in Group T compared to Group C (P＜0.05). Both groups exhibited significant reductions in NRS scores, headache index, cervical ROM, PSQI, and SAS scores at all postoperative intervals (P＜0.05), with no statistically significant intergroup differences. At 6 months postoperatively, 82.1% of Group T patients achieved "excellent/good" outcomes based on the modified MacNab criteria, compared to 62.5% in Group C. One patient in Group T experienced transient postoperative agitation, while one patient in Group C developed a puncture-site hematoma. Conclusion Combined PRF therapy (C2 dorsal root ganglion and C3 medial branch) with epidural catheter analgesia demonstrates favorable efficacy in treating cervicogenic headache. The epidural catheter significantly improves cervical ROM and sleep quality in CEH patients.
