Radiofrequency neurotomy for headache stemming from the zygapophysial joints C2/3 and C3/4.

Background: Headaches are a major socio-economic problem, and reliable and effective treatments may have an important economic impact. While many studies have investigated neck pain stemming from the zygapophysial joint, there is little data on the specific problem of headache from the zygapophysial joint C3/4.

Methods: In this investigation we included only patients who suffered from chronic headaches which had lasted for at least 12 months and were due to irritation of the zygapophysial joints (facets) of the upper cervical spine. As we aimed to prove the effectiveness of radiofrequency neurotomy in these patients, we had no randomized control group. Patients with the following underlying diseases were included in the study group: cervical fusions (followed by pseudoarthrosis); traumatic cervical fractures (not fused); arthritis.

Results: We examined the extent of pain relief on the first day after radiofrequency treatment and the duration of pain relief until recurrence of 50% of pre-coagulation pain in the whole collective and the three subgroups.

Conclusions: Our results indicate that this therapy is effective in patients with underlying diseases of primarily degenerative origin. A significant finding was that in the group of patients with arthritis, the duration and extent of pain relief were extremely short compared to the other two groups (p<0.005, U-test).