Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain — a retrospective cohort study

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.

Comparing Migraine Headache Index vs. Monthly Migraine Days Following Nerve Deactivation for Headache: A Systematic Review and Meta-Analysis

“…We identified 31 studies reporting on outcomes of headache surgery without any mention of MMD. 5,10,16,[18][19][20][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]45,49,[51][52][53]55,[66][67][68][69] This is a significant body of evidence that could exist in the databases already constructed by the study authors. If so, we suspect this omission might be attributable to a lack of awareness about the preferred outcome metrics used in the neurology literature, and we hope our work will provide evidence to standardize migraine treatment metrics across both disciplines.…”

Exploring the terminological validity of ‘chronic pain’ nursing diagnosis: A retrospective descriptive study using nursing diaries

“…Chronic neuropathic pain affects around 7% (Szok et al, 2019) of the general population and is due to injuries or central and peripheral ‘nervous system diseases’ (AC), as in 7.4% of the analysed records. In the sample, ‘nerve compression syndromes’ (AC) are associated with chronic pain in 48.5% of cases; in particular, compression of the cervical spine is linked to the onset of persistent headache and neck pain (Eskilsson et al, 2021). In our study, it was found that an ‘imbalance of neurotransmitters, neuromodulators and receptors’ (AC) is associated with chronic pain.…”

Morphological features of the greater occipital nerve and its possible importance for interventional procedures

“…Success of GONB may vary depending on the techniques used, concerning the landmarks (Nair et al, 2018 ). On the other hand, in some cases, GONB does not alleviate these symptoms (Dilli et al, 2015 ; Eskilsson et al, 2021 ; Kashipazha et al, 2014 ), possibly due to anatomical variations and/or differences in the topographical location of GON (Ducic et al, 2009 ; Huanmanop et al, 2021 ; Junewicz et al, 2013 ; Natsis et al, 2006 ; Won et al, 2018 ). Although it is considered to be safe, repeated corticosteroid injections may cause complications such as Cushing's syndrome (Lavin & Workman, 2001 ) or neck muscle weakness (Ducic et al, 2009 ).…”