Anja Eskilsson1, Eva Ageberg2, Hans Ericson3, Niklas Marklund4,5, Leif Anderberg4. 1. Department of Clinical Sciences Lund, Neurosurgery, Lund University, 221 85, Lund, Sweden. anja.eskilsson@med.lu.se. 2. Department of Health Sciences, Lund University, Lund, Sweden. 3. Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden. 4. Department of Clinical Sciences Lund, Neurosurgery, Lund University, 221 85, Lund, Sweden. 5. Skane University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
Abstract
BACKGROUND: Compression of the greater occipital nerve (GON) may contribute to chronic headache, neck pain, and migraine in a subset of patients. We aimed to evaluate whether GON decompression could reduce pain and improve quality of life in patients with occipital neuralgia and chronic headache and neck pain. METHODS: In this retrospective cohort study, selected patients with neck pain and headache referred to a single neurosurgical center were analyzed. Patients (n = 22) with suspected GON neuralgia based on nerve block or clinical criteria were included. All patients presented with occipital pain spreading frontally and to the neck in various degree. Surgical decompression was performed under local anesthesia. Follow-up was made by an assessor not involved in the treatment of the patients, by telephone 2-5 years after the surgical procedure and an interview protocol was used to collect information. The data from the follow-up protocols were then analyzed and reported. RESULTS: When analyzing the follow-up protocols, decreased headache/migraine was reported in 77% and neck pain was reduced in 55% of the patients. CONCLUSIONS: Decompression of GON(s) may reduce neck pain and headache in selected patients with persistent headache, neck pain, and clinical signs of GON neuralgia. Based on the limitations of the present retrospective study, the results should be considered with caution.
BACKGROUND: Compression of the greater occipital nerve (GON) may contribute to chronic headache, neck pain, and migraine in a subset of patients. We aimed to evaluate whether GON decompression could reduce pain and improve quality of life in patients with occipital neuralgia and chronic headache and neck pain. METHODS: In this retrospective cohort study, selected patients with neck pain and headache referred to a single neurosurgical center were analyzed. Patients (n = 22) with suspected GON neuralgia based on nerve block or clinical criteria were included. All patients presented with occipital pain spreading frontally and to the neck in various degree. Surgical decompression was performed under local anesthesia. Follow-up was made by an assessor not involved in the treatment of the patients, by telephone 2-5 years after the surgical procedure and an interview protocol was used to collect information. The data from the follow-up protocols were then analyzed and reported. RESULTS: When analyzing the follow-up protocols, decreased headache/migraine was reported in 77% and neck pain was reduced in 55% of the patients. CONCLUSIONS: Decompression of GON(s) may reduce neck pain and headache in selected patients with persistent headache, neck pain, and clinical signs of GON neuralgia. Based on the limitations of the present retrospective study, the results should be considered with caution.
Entities:
Keywords:
Decompression; Greater occipital nerve; Headache; Neuralgia; Surgery
Authors: Steven P Cohen; B Lee Peterlin; Larry Fulton; Edward T Neely; Connie Kurihara; Anita Gupta; Jimmy Mali; Diana C Fu; Michael B Jacobs; Anthony R Plunkett; Aubrey J Verdun; Milan P Stojanovic; Steven Hanling; Octav Constantinescu; Ronald L White; Brian C McLean; Paul F Pasquina; Zirong Zhao Journal: Pain Date: 2015-12 Impact factor: 7.926