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目的:通过超声图像灰度值分析寰枢关节水平半棘肌退变与颈源性头痛的关系及针刀松解术与脉冲射频术对颈源性头痛的疗效。方法:收集2020年12月至2021年2月于华中科技大学深圳协和医院疼痛科住院的颈源性头痛患者50例，年龄20~80岁，以SPSS 22.0软件将其随机分为针刀松解组和脉冲射频组，每组25例。治疗前通过盈谷软件在每例患者颈椎螺旋CT上采集寰齿侧间隙数据信息，以肌骨超声采集患者双侧寰枢关节水平超声图像，并用Photoshop采集超声图片中半棘肌的超声灰度值。两组患者分别接受超声引导下头痛侧寰枢关节水平半棘肌针刀松解治疗与C型臂引导下Cn 2神经脉冲射频治疗，记录两组患者治疗前及治疗后1、3、7 d，1及3个月时视觉模拟评分（VAS）。n 结果:颈源性头痛疼痛侧别与寰齿侧间隙较宽侧别无关联（n χ2=0.45n , P=0.832）。寰枢关节水平颈半棘肌超声图像灰度值疼痛侧为（97±21）较非疼痛侧的（71±24）升高，差异有统计学意义（n P<0.001）。两组患者治疗前、后不同时点VAS评分差异均有统计学意义（n P均n <0.001）；两组组间比较，VAS评分差异无统计学意义（n P=0.662），但时间因素和分组交互作用差异有统计学意义（n P<0.001），针刀松解组较脉冲射频组随时间延长对颈源性头痛患者疼痛改善更佳（n P<0.05）。两组患者治疗后3个月时，针刀松解组较脉冲射频组VAS评分更低，差异有统计学意义（n P<0.05）。n 结论:颈源性头痛患者疼痛侧寰枢关节水平半棘肌超声灰度值较非疼痛侧升高，提示患侧寰枢关节水平半棘肌退变程度高；超声引导下Cn 2神经根针刀松解治疗较神经根脉冲射频治疗对颈源性头痛治疗效果更佳。n “,”Objective:To analyze the relationship between atlantoaxial hemispinous muscle degeneration and cervicogenic headache and compare the efficacy of the short-term efficacy of semispinous muscle acupotomy and radiofrequency therapy in cervicogenic headache.Methods:A total of 50 patients with cervicogenic headache, aged 20-80 years, admitted to the Department of Painology, Shenzhen Union Hospital, Huazhong University of Science and Technology from December 2020 to February 2021, were randomly divided into acupotomy group and pulse radiofrequency group, 25 cases in each group. The atlanto odontoid space data of each patient were collected on the cervical spiral CT by Yinggu software in the hospital medical record system before the treatment. The ultrasound images of bilateral atlantoaxial joints region were collected by musculoskeletal ultrasound, and the ultrasound gray value of hemispinous muscle was collected by Photoshop, then the patients were treated with ultrasound-guided acupotomy on hemispinous or pulse radiofrequency treatment on Cn 2 nerve root. The visual analogue scale (VAS) was recorded before the treatment and 1 day, 3 days, 7 days, 1 month and 3 months after the treatment.n Results:There was no correlation between the pain side of cervicogenic headache patients and the wider side of atlanto odontoid space (n χ2=0.45, n P=0.832). The gray value of ultrasound image of cervical semispinous at atlantoaxial joint level was higher in the pain side (97±21) than that in the no pain side (71±24), with statistical significantce (n P<0.001). There were significant differences in VAS at different time points before and after the treatment (all n P<0.001), but no significant difference between the two groups (n P=0.662), with differences in interaction between time and groups factors. The improvement of VAS was better in the acupotomy group than that in the pulse radiofrequency group at 3 months after the treatment (n P<0.05).n Conclusion:The ultrasound gray value of hemispinous atlantoaxial joint level increased in patients with cervicogenic headache, means that the degeneration degree of horizontal hemispinous muscle of atlantoaxial joint is high; and the needle acupotomy has better efficacy than the pulse radiofrequency at Cn 2 nerve root under ultrasound guide for the treatment of patients with cervicogenic headache.n