A Retrospective Study of Ultrasound-Guided C2 Transverse Process Injection with Myofascial Release for Cervicogenic Headache

Lijun Hao,1 Yinnan Guo,1 Liping Song,1 Lin Zhang,2 Jun Mi1 1Department of Pain Medicine, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China; 2Department of Anesthesiology, Shanxi Medical University, Taiyuan, People’s Republic of ChinaCorrespondence: Lijun Hao, Department of Pain Medicine, Shanxi Provincial People’s Hospital, No. 29 Shuangtasi Street, Yingze District, Taiyuan, Shanxi, 030001, People’s Republic of China, Tel +8618835120933, Email haolijun@sxmu.edu.cnObjective: To evaluate the efficacy and safety of ultrasound-guided myofascial hydrodissection between the obliquus capitis inferior and semispinalis capitis muscles combined with C2 transverse process injection in patients with cervicogenic headache (CGH).Methods: This retrospective study analyzed 80 patients with CGH who received four sessions of ultrasound-guided treatment from January to December 2024. Each session consisted of hydrodissection of the obliquus capitis inferior and semispinalis capitis muscles along with C2 transverse process injections of lidocaine and corticosteroids. Pain intensity, disability, and headache impact were assessed using the numeric rating scale (NRS), neck disability index (NDI), and headache impact test-6 (HIT-6) at baseline, 1 week, 1 month, 3 months, and 6 months.Results: All patients completed the treatment without serious complications. Notable and consistent reductions in NRS, NDI, and HIT-6 scores were observed at all follow-up points (P < 0.05). Minor transient adverse events, including dizziness and mild discomfort, resolved spontaneously.Conclusion: This retrospective study suggests that ultrasound-guided myofascial hydrodissection combined with C2 transverse process injection may provide potentially meaningful pain relief and functional improvement in patients with CGH. However, given the uncontrolled retrospective design, the findings should be interpreted with caution and require confirmation in prospective controlled trials.Keywords: cervicogenic headache, ultrasound-guided injection, myofascial hydrodissection, C2 transverse process, retrospective study, pain management