Evidence-Based Patient Selection in Headache Surgery: Impact of Preoperative Radiofrequency Ablation on Surgical Outcomes.
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
17
5
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Radiofrequency ablation (RFA) of the greater occipital nerve (GON) is a minimally invasive treatment option commonly used in patients with occipital neuralgia. Patients who undergo occipital surgery for headaches after failed RFA treatment present a unique opportunity to evaluate RFA-treated occipital nerves and determine the impact on headache surgery outcomes. Of 115 patients who underwent headache surgery at the occipital site, 29 had a history of RFA treatment. Migraine Headache Index, Pain Self- Efficacy Questionnaire, and Pain Health Questionnaire-2 outcome scores were recorded preoperatively and at follow-up visits. Intraoperative macroscopic nerve damage and surgical outcomes were compared between RFA-treated and non-RFA-treated patients. RFA-treated patients had a higher rate of macroscopic nerve damage (45%) than non-RFA-treated patients (24%) ( P = 0.03), and they were significantly more likely to require a second operation at the site of primary decompression (27.6% versus 5.8%; P = 0.001) and GON transection (13.8% versus 3.5%; P = 0.04). Outcome scores at the last follow-up visit showed no statistically significant difference between RFA-treated and non-RFA-treated patients ( P = 0.96). RFA-treated patients can ultimately achieve outcomes that are not significantly different from non-RFA-treated patients in occipital headache surgery. However, a higher number of secondary operations at the site of primary decompression and nerve transection are required to treat refractory symptoms. RFA-treated patients should be counseled about an increased risk of same-site surgery and possible GON transection to achieve acceptable outcomes. Therapeutic, III.
Sections du résumé
BACKGROUND
Radiofrequency ablation (RFA) of the greater occipital nerve (GON) is a minimally invasive treatment option commonly used in patients with occipital neuralgia. Patients who undergo occipital surgery for headaches after failed RFA treatment present a unique opportunity to evaluate RFA-treated occipital nerves and determine the impact on headache surgery outcomes.
METHODS
Of 115 patients who underwent headache surgery at the occipital site, 29 had a history of RFA treatment. Migraine Headache Index, Pain Self- Efficacy Questionnaire, and Pain Health Questionnaire-2 outcome scores were recorded preoperatively and at follow-up visits. Intraoperative macroscopic nerve damage and surgical outcomes were compared between RFA-treated and non-RFA-treated patients.
RESULTS
RFA-treated patients had a higher rate of macroscopic nerve damage (45%) than non-RFA-treated patients (24%) ( P = 0.03), and they were significantly more likely to require a second operation at the site of primary decompression (27.6% versus 5.8%; P = 0.001) and GON transection (13.8% versus 3.5%; P = 0.04). Outcome scores at the last follow-up visit showed no statistically significant difference between RFA-treated and non-RFA-treated patients ( P = 0.96).
CONCLUSIONS
RFA-treated patients can ultimately achieve outcomes that are not significantly different from non-RFA-treated patients in occipital headache surgery. However, a higher number of secondary operations at the site of primary decompression and nerve transection are required to treat refractory symptoms. RFA-treated patients should be counseled about an increased risk of same-site surgery and possible GON transection to achieve acceptable outcomes.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, III.
Identifiants
pubmed: 36728939
doi: 10.1097/PRS.0000000000010044
pii: 00006534-202305000-00029
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1071-1077Informations de copyright
Copyright © 2022 by the American Society of Plastic Surgeons.
Références
Perry CJ, Blake P, Buettner C, et al. Upregulation of inflammatory gene transcripts in periosteum of chronic migraineurs: implications for extracranial origin of headache. Ann Neurol. 2016;79:1000–1013.
Dodick D. Migraine. Lancet. 2018;391:1315–1330.
Ashina M, Hansen JM, Do TP, Melo-Carrillo A, Burstein R, Moskowitz MA. Migraine and the trigeminovascular system: 40 years and counting. Lancet Neurol. 2019;18:795–804.
Gfrerer L, Hulsen JH, McLeod MD, Wright EJ, Austen WG Jr. Migraine surgery: an all or nothing phenomenon? Prospective evaluation of surgical outcomes. Ann Surg. 2018;269:994–999.
Puledda F, Goadsby PJ. An update on non-pharmacological neuromodulation for the acute and preventive treatment of migraine. Headache. 2017;57:685–691.
Stovner L, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.
Berger A, Bloudek LM, Varon SF, Oster G. Adherence with migraine prophylaxis in clinical practice. Pain Pract. 2012;12:541–549.
Blumenfeld AM, Bloudek LM, Becker WJ, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: results from the second international burden of migraine study (IBMS-II). Headache. 2013;53:644–655.
Vecsei L, Majlath Z, Szok D, Csati A, Tajti J. Drug safety and tolerability in prophylactic migraine treatment. Expert Opin Drug Saf. 2015;14:667–681.
Tassorelli C, Grazzi L, de Tommaso M, et al. Noninvasive vagus nerve stimulation as acute therapy for migraine: the randomized PRESTO study. Neurology. 2018;91:e364–e373.
Abd-Elsayed A, Falls C, Luo S. Radiofrequency ablation for treating headache: a follow-up study. Curr Pain Headache Rep. 2020;24:15.
Deng Y, Zheng M, He L, Yang J, Yu G, Wang J. A head-to-head comparison of percutaneous mastoid electrical stimulator and supraorbital transcutaneous stimulator in the prevention of migraine: a prospective, randomized controlled study. Neuromodulation. 2020;23:770–777.
Halker Singh RB, Ailani J, Robbins MS. Neuromodulation for the acute and preventive therapy of migraine and cluster headache. Headache. 2019;59:33–49.
Hoffman LM, Abd-Elsayed A, Burroughs TJ, Sachdeva H. Treatment of occipital neuralgia by thermal radiofrequency ablation. Ochsner J. 2018;18:209–214.
Kapural L, Mekhail N. Radiofrequency ablation for chronic pain control. Curr Pain Headache Rep. 2001;5:517–525.
Kapural L, Stillman M, Kapural M, McIntyre P, Guirgius M, Mekhail N. Botulinum toxin occipital nerve block for the treatment of severe occipital neuralgia: a case series. Pain Pract. 2007;7:337–340.
Lai YH, Huang YC, Huang LT, Chen RM, Chen C. Cervical noninvasive vagus nerve stimulation for migraine and cluster headache: a systematic review and meta-analysis. Neuromodulation. 2020;23:721–731.
Lan L, Zhang X, Li X, Rong X, Peng Y. The efficacy of transcranial magnetic stimulation on migraine: a meta-analysis of randomized controlled trials. J Headache Pain. 2017;18:86.
Lipton RB, Dodick DW, Silberstein SD, et al. Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. Lancet Neurol. 2010;9:373–380.
Misra UK, Kalita J, Bhoi SK. High-rate repetitive transcranial magnetic stimulation in migraine prophylaxis: a randomized, placebo-controlled study. J Neurol. 2013;260:2793–2801.
Rocha S, Melo L, Boudoux C, Foerster A, Araujo D, Monte-Silva K. Transcranial direct current stimulation in the prophylactic treatment of migraine based on interictal visual cortex excitability abnormalities: a pilot randomized controlled trial. J Neurol Sci. 2015;349:33–39.
Schuster NM, Rapoport AM. New strategies for the treatment and prevention of primary headache disorders. Nat Rev Neurol. 2016;12:635–650.
Yuan H, Silberstein SD. Vagus nerve stimulation and headache. Headache. 2017;57(Suppl):29–33.
Guyuron B. Migraine Surgery. New YorkThieme; 2018.
Gfrerer L, Guyuron B. Surgical treatment of migraine headaches. Acta Neurol Belg. 2017;117:27–32.
Gfrerer L, Austen WG Jr, Janis JE. Migraine surgery. Plast Reconstr Surg Glob Open. 2019;7:e2291.
Uematsu S, Udvarhelyi GB, Benson DW, Siebens AA. Percutaneous radiofrequency rhizotomy. Surg Neurol. 1974;2:319–325.
Sindou M, Fischer G, Goutelle A, Schott B, Mansuy L. Selective posterior rhizotomy in the treatment of spasticity (in French). Rev Neurol (Paris). 1974;130:201–216.
Gazelka HM, Knievel S, Mauck WD, et al. Incidence of neuropathic pain after radiofrequency denervation of the third occipital nerve. J Pain Res. 2014;7:195–198.
Kemp WJ III, Tubbs RS, Cohen-Gadol AA. The innervation of the scalp: a comprehensive review including anatomy, pathology, and neurosurgical correlates. Surg Neurol Int. 2011;2:178.
Mosser SW, Guyuron B, Janis JE, Rohrich RJ. The anatomy of the greater occipital nerve: implications for the etiology of migraine headaches. Plast Reconstr Surg. 2004;113:693–697.
Dash KS, Janis JE, Guyuron B. The lesser and third occipital nerves and migraine headaches. Plast Reconstr Surg. 2005;115:1752–1758.
Khansa I, Barker J, Janis JE. Sensory Nerves of the Head. New York: Thieme; 2015.
Geuna S, Raimondo S, Ronchi G, et al. Chapter 3: Histology of the peripheral nerve and changes occurring during nerve regeneration. Int Rev Neurobiol. 2009;87:27–46.
Taha JM, Tew JM Jr. Treatment of trigeminal neuralgia by percutaneous radiofrequency rhizotomy. Neurosurg Clin N Am. 1997;8:31–40.
Hamer JF, Purath TA. Response of cervicogenic headaches and occipital neuralgia to radiofrequency ablation of the C2 dorsal root ganglion and/or third occipital nerve. Headache. 2014;54:500–510.
Schoellnast H, Monette S, Ezell PC, et al. Acute and subacute effects of irreversible electroporation on nerves: experimental study in a pig model. Radiology. 2011;260:421–427.
Schoellnast H, Monette S, Ezell PC, et al. The delayed effects of irreversible electroporation ablation on nerves. Eur Radiol. 2013;23:375–380.
Bunch TJ, Bruce GK, Mahapatra S, et al. Mechanisms of phrenic nerve injury during radiofrequency ablation at the pulmonary vein orifice. J Cardiovasc Electrophysiol. 2005;16:1318–1325.
Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005;115:1–9.
Gfrerer L, Lans J, Faulkner HR, Nota S, Bot AGJ, Austen WG Jr. Ability to cope with pain puts migraine surgery patients in perspective. Plast Reconstr Surg. 2018;141:169–174.
Arrieta J, Aguerrebere M, Raviola G, et al. Validity and utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for screening and diagnosis of depression in rural Chiapas, Mexico: a cross-sectional study. J Clin Psychol. 2017;73:1076–1090.
Gfrerer L, Hansdorfer MA, Ortiz R, Chartier C, Nealon KP, Austen WG Jr. Muscle fascia changes in patients with occipital neuralgia, headache, or migraine. Plast Reconstr Surg. 2021;147:176–180.
Abd-Elsayed A. The ALblation technique for treating migraine headache. Curr Pain Headache Rep. 2020;24:29.
Vanelderen P, Rouwette T, De Vooght P, et al. Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up. Reg Anesth Pain Med. 2010;35:148–151.
Protasoni M, Reguzzoni M, Sangiorgi S, et al. Pulsed radiofrequency effects on the lumbar ganglion of the rat dorsal root: a morphological light and transmission electron microscopy study at acute stage. Eur Spine J. 2009;18:473–478.
Ducic I, Felder JM III, Khan N, Youn S. Greater occipital nerve excision for occipital neuralgia refractory to nerve decompression. Ann Plast Surg. 2014;72:184–187.