■颈源性头痛(CEH)是由上颈椎功能障碍和相关的结构和软组织异常引起的疾病,显著影响患者生活质量。为了获得更好的治疗效果,我们提出了一种新的超声引导的“三合一”方法加筋膜平面(IFP)阻滞治疗CEH。这种方法允许调节C2背根神经节(DRG),枕第三神经(TON),和C3内侧支一点穿刺。此外,它允许IFP块之间的上颈部和枕骨肌肉在同一扫描平面内。
■我们在我们的疼痛诊所评估了2021年7月至2022年12月诊断为CEH的患者。我们包括那些对保守治疗和单枕骨神经阻滞没有反应的人,因此,使用“三合一”方法加IFP阻滞接受神经阻滞或脉冲射频(PRF)。超声引导的C2DRG穿刺程序的准确性通过C臂透视和PRF的感觉测试得到证实。在1、3和6个月的电话随访期间,使用数字评定量表(NRS)评分评估这些干预措施的治疗效果。
■利用“三合一”方法,共有5例诊断为CEH的患者接受了神经阻滞加IFP阻滞,2例患者行PRF加IFP阻滞。采用超声引导C2DRG穿刺程序,通过透视和PRF的感觉测试确认了针尖的正确放置。值得注意的是,所有病例均未出现与该方法相关的任何并发症.随后的随访评估显示,所有患者的CEHNRS评分均有所改善。
■超声引导的“三合一”方法加IFP阻滞可能是治疗CEH的潜在有效方法。
UNASSIGNED: Cervicogenic headache (CEH) is a condition resulting from upper cervical spine dysfunction and associated structural and soft tissue abnormalities, significantly impacting patients\' quality of life. To acquire better therapeutic results, we presented a novel ultrasound-guided \"three in one\" approach plus interfascial plane (IFP) blocks for the treatment of CEH. This approach allows for the modulation of C2 dorsal root ganglion (DRG), third occipital nerve (TON), and C3 medial branch with one-point puncture. Additionally, it allows for IFP blocks between the upper neck and occipital muscles within the same scanning plane.
UNASSIGNED: We evaluated patients diagnosed with CEH from July 2021 to December 2022 in our pain clinic. We included those who did not respond to conservative treatment and single occipital nerve block, therefore received nerve block or pulsed radiofrequency (PRF) using the \"Three in One\" approach plus IFP blocks. The accuracy of the ultrasound-guided C2 DRG puncture procedures was confirmed through fluoroscopy with C-arm and the sensory testing of PRF. The therapeutic effect of these interventions was assessed using the numerical rating scale (NRS) scores during telephone follow-ups at 1, 3, and 6 months.
UNASSIGNED: Utilizing the \"Three in One\" approach, a total of 5 patients diagnosed with CEH underwent nerve block plus IFP blocks, while 2 patients underwent PRF plus IFP blocks. Employing ultrasound-guided C2 DRG puncture procedures, the needle tip\'s correct placement was confirmed through both fluoroscopy and sensory testing of PRF. Notably, none of the cases experienced any complications associated with the approach. Subsequent follow-up assessments revealed an improvement in the NRS scores for CEH in all patients.
UNASSIGNED: The ultrasound-guided \"Three in One\" approach plus IFP blocks may be a potential effective method for the treatment of CEH.