A Novel Ultrasound-Guided "Three in One" Approach Plus Interfascial Plane Blocks for the Treatment of Cervicogenic Headache.

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI:10.2147/LRA.S446667

Danxu Ma, Abulaihaiti Maimaitimin, Yun Wang

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Abstract

Objective: 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.

Patients and methods: 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.

Results: 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.

Conclusion: The ultrasound-guided "Three in One" approach plus IFP blocks may be a potential effective method for the treatment of CEH.

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治疗颈源性头痛的新型超声引导 "三合一 "疗法加筋膜间平面阻滞术

目的：颈源性头痛（CEH颈源性头痛（CEH）是一种由上颈椎功能障碍及相关结构和软组织异常引起的疾病，严重影响患者的生活质量。为了获得更好的治疗效果，我们提出了一种新颖的超声引导 "三合一 "方法加筋膜间平面（IFP）阻滞治疗颈源性头痛。这种方法可通过单点穿刺调节 C2 背根神经节 (DRG)、第三枕神经 (TON) 和 C3 内侧支。此外，它还能在同一扫描平面内对上颈部和枕部肌肉进行 IFP 阻滞：我们对 2021 年 7 月至 2022 年 12 月期间在疼痛诊所确诊为 CEH 的患者进行了评估。我们评估了 2021 年 7 月至 2022 年 12 月期间在我院疼痛门诊确诊为 CEH 的患者，其中包括对保守治疗和单一枕神经阻滞治疗无效的患者，因此他们接受了神经阻滞或脉冲射频（PRF）治疗，采用 "三合一 "方法加 IFP 阻滞治疗。超声引导下的 C2 DRG 穿刺程序的准确性通过 C 臂透视和 PRF 的感觉测试得到了证实。在 1 个月、3 个月和 6 个月的电话随访中，使用数字评分量表（NRS）评分评估了这些干预措施的治疗效果：利用 "三合一 "方法，共有 5 名确诊为 CEH 的患者接受了神经阻滞加 IFP 阻滞治疗，2 名患者接受了 PRF 加 IFP 阻滞治疗。采用超声引导的 C2 DRG 穿刺程序，通过透视和 PRF 的感觉测试确认针尖的正确位置。值得注意的是，所有病例均未出现与该方法相关的并发症。随后的随访评估显示，所有患者的 CEH NRS 评分均有改善：结论：超声引导下的 "三合一 "方法加 IFP 阻滞可能是治疗 CEH 的一种有效方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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