Efficacy of Pulsed Radiofrequency on Cervical 2-3 Posterior Medial Branches in Treating Chronic Migraine: A Randomized, Controlled, and Double-Blind Trial.

Yuecheng Yang,Yinghui Fan,Xuehua Huang,Ke Ma,Yingwei Wang

doi:10.1155/2015/690856

Abstract

Objective. The aim of this study was to examine the efficacy and safety of pulsed radiofrequency (PRF) in the treatment of chronic migraine (CM) on cervical 2-3 posterior medial branches. Methods. This randomized, double-blind, and controlled clinical trial included 40 subjects with CM, who were randomly divided into two groups: treatment (treated by PRF) and sham (treated by sham treatment). Pain intensity, headache duration (days), the Migraine Disability Assessment Questionnaire (MIDAS), and aspirin dose taken by patients were evaluated at 1, 2, and 6 months after the intervention. Side effects were observed from the time of treatment and throughout the follow-up period. Results. During the follow-up, pain intensity, headache duration (days), disability score, and the analgesic dose were significantly improved in the treatment group compared to the sham group (P < 0.001) and the baseline (P < 0.001) at all measured time points after intervention. No serious complications were reported. Conclusion. PRF on the cervical 2-3 posterior medial branches could provide satisfactory efficacy in the treatment of CM without obvious adverse effects.

Highlights

chronic migraine (CM) is diagnosed in patients who suffer from headache at least 15 days per month or who have at least 8 days per month in which the headaches are associated with symptoms that meet the diagnostic criteria for migraine
Patients were considered eligible for the study if they met the following inclusion criteria: (1) the patient was older than 18 years of age, (2) the patient had suffered for more than 6 months from CM, (3) CM was diagnosed strictly according to the Third Edition of the International Classification of Headache Disorders (ICHD-III) [20], and (4) the patient experienced a greater than 30% reduction in pain after occipital nerve block (ONB) of the cervical 2-3 posterior medial branches before the trial
The mean visual analogue scale (VAS) decreased by 2.52 points in the treatment group compared to 0.55 points in the sham group at the 6-month follow-up time point

Summary

Introduction

CM is diagnosed in patients who suffer from headache at least 15 days per month or who have at least 8 days per month in which the headaches are associated with symptoms that meet the diagnostic criteria for migraine. Migraine affects approximately 2% of patients worldwide [1]. A high frequency of migraines is associated with an increased risk of neck pain and disability [2]. The overuse of medicine such as opiates and triptans was one of the most important risks of migraine progression [6, 7]. Effective invasive treatments on CM could relieve the pain and avoid the possible progression of migraine derived from the medicine overuse

Methods

Results

Conclusion