High-dose pulsed radiofrequency of the C2 dorsal root ganglion versus nerve block for cervicogenic headache with ocular symptoms: A retrospective cohort study.

ObjectivesTo compare the efficacy of C2 dorsal root ganglion high-dose pulsed radiofrequency and nerve block in managing cervicogenic headache with ocular symptoms.MethodsThis retrospective study analyzed 55 cervicogenic headache patients with ocular symptoms (blurred vision, eye pain, or photophobia) treated at the Second Hospital of Dalian Medical University from January 2022 to December 2024. Patients who received either high-dose pulsed radiofrequency (Group A, n = 29) or nerve block therapy (Group B, n = 26), both targeting the C2 dorsal root ganglion, were consecutively enrolled at our center. Pain intensity and ocular symptom severity were assessed using the numeric rating scale and Ocular Surface Disease Index, respectively, before treatment and at 1 day, 1 week, and 1 month after treatment.ResultsThe primary outcome was the change in pain intensity (as assessed using the numeric rating scale). Numeric rating scale scores at all postoperative time points in both groups were significantly reduced compared with preoperative values (all p < 0.05), with the reduction in the numeric rating scale score at 1 month postoperatively in group A (Δ = 4.45 ± 1.23) being significantly greater than that in group B (Δ = 3.11 ± 1.18; between-group comparison: p < 0.05). Secondary outcomes included ocular symptoms (assessed using the Ocular Surface Disease Index) and overall clinical response rate; the Ocular Surface Disease Index value in group A decreased more significantly than that in group B (p < 0.05); the overall clinical response rate in group A (93%) was significantly higher than that in group B (39%) (p < 0.01).ConclusionsBoth high-dose pulsed radiofrequency and nerve block therapy effectively reduce pain associated with cervicogenic headache. High-dose pulsed radiofrequency therapy was superior to nerve block therapy in terms of superior pain relief, improved ocular symptoms, and higher overall clinical response rate.