Evaluation of the effectiveness of CT-guided infiltration in the treatment of Arnold's neuralgia

The aim of this study was to evaluate the effectiveness of computed tomography (CT)-guided infiltration in the treatment of Arnold's neuralgia. A retrospective study included 31 patients suffering from Arnold's neuralgia and having undergone a total of 45 CT-guided infiltrations of the greater occipital nerve (GON), in a proximal site (emergence of the GON, technique 1, n = 24) or in two proximal sites (emergence of the GON and at the site of the first bend of the GON drawn by the GON, technique 2, n = 21). Infiltration was considered to be effective when pain relief was equal to or greater than 50% for at least 1 month. There was no significant difference between the two techniques regarding immediate pain relief effect (53.3% for technique 1 vs. 60.5% for technique 2, p = 0.5), but technique 2 yielded better persistence of pain relief effect (p 0.01), leading to a significantly higher percentage of effective infiltrations with technique 2 (p = 0.03). Infiltrations carried out in a single site yield results that are comparable to those previously published. Infiltrations in two sites provide significantly better results and should now be preferred to other single-site techniques in order to reduce the rate of failure or recurrence of Arnold's neuralgia. (orig.)