Response of Cervicogenic Headaches and Occipital Neuralgia to Radiofrequency Ablation of the C2 Dorsal Root Ganglion and/or Third Occipital Nerve

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Abstract
Objective: This article investigates the degree and duration of pain relief from cervicogenic headaches or occipital neuralgia following treatment with radiofrequency ablation of the C 2 dorsal root ganglion and/or third occipital nerves. It also addresses the procedure's complication rate and patient's willingness to repeat the procedure if severe symptoms recur. Methods: This is a single‐center retrospective observational study of 40 patients with refractory cervicogenic headaches and or occipital neuralgia. Patients were all referred by a headache specialty clinic for evaluation for radiofrequency ablation of the C 2 dorsal root ganglion and/or third occipital nerves. After treatment, patients were followed for a minimum of 6 months to a year. Patient demographics and the results of radiofrequency ablation were recorded on the same day, after 3‐4 days, and at 6 months to 1 year following treatment. Results: Thirty‐five percent of patients reported 100% pain relief and 70% reported 80% or greater pain relief. The mean duration of improvement is 22.35 weeks. Complication rate was 12‐13%. 92.5% of patients reported they would undergo the procedure again if severe symptoms returned. Conclusions: Radiofrequency ablation of the C 2 dorsal root ganglion and/or third occipital nerve can provide many months of greater than 50% pain relief in the vast majority of recipients with an expected length of symptom improvement of 5‐6 months.

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