Radiofrquency Targeting Mid Cervical Medial Branches vs GON in Cervicogenic Headache

Clinical Efficacy of Pulsed Radiofrequency Treatment Targeting the Mid Cervical Medial Branches Versus Greater Occipital Nerve for Cervicogenic Headache

To detect the Clinical efficacy of pulsed radiofrequency treatment targeting the mid cervical medial branches versus greater occipital nerve for cervicogenic headache

Cervicogenic headache (CHA) is one of the secondary headache disorders. The prevalence of CHA was estimated to be ~4.1%, and most of the patients affected by CHA report un-resolved, recurrent throbbing pain. it has been treated with many treatment modalities, such as the administration of medi-cines, physiotherapy, transcutaneous electrical nerve stimulation, and interventional pro-cedures. However, these treatments do not result in long-term relief for many patients and need to be repeated Pulsed radiofrequency treatment (PRF) is one of the modalities used to treat CHA . CHA has been known to originate from the convergence of the 3 upper cervical and tri-geminal afferents, and therefore, many physicians have performed PRF targeting the upper cervical structures (occipital nerve, C2 dorsal root ganglion). However, this results in only short-term pain relief in the posterior head, and it can lead to some complications, such as vascular and nerve injuries. Because of these limitations, we will attempt PRF targeting the mid-cervical medial branches

two groups of patients diagnosed with cervicogenic headache Will be randomly subjected to either RF or greater occipital nerve block

triple blind study (participant ,investigator and outcome assessor) will be masked and will not konw what is the type of treatment patients receive

Assessment of pain will be done using VAS The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain."

Inclusion Criteria: medically stable outpatients with confirmed diagnosis of cervicogenic headache according to International Headache society Are reliable and willing to make themselves available for the duration of the study and are willing to follow up. Men or women older than 18years of age . clear written informed consent from each participant in the trial. Exclusion Criteria: 1)pregnants, breastfeeding, or willing to be pregnant during the study. 2)presence of clinically significant medical or psychiatric condition that may increase the risk associated with the study 3)participation in any other type of medical research that may interfere with the interpretation of the study. 4). bilateral migraine headache 5)patients with haemocoagulation disorders, local infection or those who refused to consent

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