TITLE:
Repeat RF Ablation of C2 and Third Occipital Nerves for Recurrent Occipital Neuralgia and Cervicogenic Headaches
AUTHORS:
John F. Hamer, Traci A. Purath
KEYWORDS:
Occipital Neuralgia, Cervicogenic Headache, Radiofrequency Ablation
JOURNAL NAME:
World Journal of Neuroscience,
Vol.6 No.4,
October
19,
2016
ABSTRACT: Objective: To address
the degree and duration of pain relief from recurrent cervicogenic headaches
and/or occipital neuralgia following retreatment with radiofrequency ablation
of the C2 dorsal root ganglion and/or third occipital nerves; to review outcomes including duration and degree of
pain relief; to evaluate procedure’s
complication rate and patient’s willingness to repeat the procedure; to compare effectiveness of
the most recent RF ablation to patient’s first RF ablation. Methods: This is a single-center retrospective
observational study of 23 patients with recurrent cervicogenic headaches and/or occipital neuralgia
treated with repeated RF ablation of the C2 dorsal root ganglion and/or third occipital
nerves. All patients receiving treatment from January 2010 to July 2014 are
included in this single site retrospective study. This is an IRB approved
medical chart review study. Results: 22 of 23 patients underwent follow-up. An average of 86.5% of
participants reported pain relief on average of 25.4 weeks at time of follow-up. 41% reported side effects including suboccipital hyperesthesia and/or
ear discomfort, 95% reported willingness to repeat the procedure again if
severe symptoms recurred, 59% of patients reported the most recent RF ablation had the same results as the first,
32% reported the most recent RF was the most effective, and 9% reported that
the first RF was the most effective. Conclusion: Repeated RF ablation is a feasible option for recurrent cervicogenic headaches
and/or occipital neuralgia. Effectiveness of repeat intervention is the same or
better than the first ablation. Though there was a higher likelihood of side
effects including suboccipital neuralgia and/or ear discomfort on repeat treatment, the side
effects were generally well tolerated.