Korean J Pain.  2013 Apr;26(2):186-190. 10.3344/kjp.2013.26.2.186.

Ultrasound-guided Pulsed Radiofrequency of the Third Occipital Nerve

• Kim ED
• Kim YH
• Park CM
• Kwak JA
• Moon DE

• KMID: 1978667
• DOI: http://doi.org/10.3344/kjp.2013.26.2.186

Abstract

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.

Keyword

pulsed radiofrequency; third occipital nerve; ultrasound

MeSH Terms

Arthralgia
Denervation
Headache
Humans
Joints
Male
Neck Pain
Post-Traumatic Headache

Figure

• 

  Fig. 1 Ultrasound images of pulsed radiofrequency on the third occipital nerve. Arrowheads indicate radiofrequency (RF) needle. Arrows indicate third occipital nerve. Dotted arrows indicate C3 medial branch nerve. Asterisks indicate zygapophygeal joints.

• 

  Fig. 2 Craniocaudal insertion of needle electrode using in-plane technique.

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  Fig. 3 Fluoroscopic image to confirm needle tip placement (A) and schematic drawing of TON and C3 deep medial branch nerve (B). (A) Needle electrode is placed in accurate level and in relatively perpendicular to TON. (B) Upper solid line indicates to TON. Lower dotted line indicates to C3 deep medial branch nerve. Arrow indicates to expected direction of electrode needle.

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