Minimally Invasive Interventions for Cervicogenic Headache: A Systematic Review of Targeted Anatomical Approaches and Clinical Outcomes.

OBJECTIVE

Cervicogenic headache (CEH) is a complex secondary headache arising from functional or structural abnormalities within the cervical spine. This systematic review summarizes and evaluates the clinical effectiveness and anatomical mechanisms of minimally invasive techniques targeting sites such as the C2 dorsal root ganglion (DRG) and C1-2 joint in CEH management..

METHODS

PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from January 2004 to May 2025. Studies involving minimally invasive interventions for CEH were included. Data extraction and quality appraisal were independently performed by two reviewers using the Cochrane Risk of Bias (ROB) tool and Newcastle-Ottawa Scale (NOS). Owing to heterogeneity across studies, results were narratively synthesized.

RESULTS

Twenty-three studies were included, comprising 4 randomized controlled trials (RCTs), 13 cohort studies, 1 case-control study, and 5 anatomical studies. Interventions targeting the C2 DRG, C1-2 joint, cervical discs, deep cervical plexus, and greater occipital nerve showed consistent short-term pain relief and improved quality of life. However, substantial heterogeneity in treatment protocols and limited long-term data restrict definitive conclusions. Most studies demonstrated moderate-to-high methodological quality.

CONCLUSION

This review integrates clinical and anatomical evidence to clarify how target-specific interventions influence CEH outcomes. The findings highlight the importance of anatomical precision in guiding individualized interventional strategies and provide a theoretical framework for optimizing future treatment paradigms.