Percutaneous full-endoscopic C2 ganglionectomy for the treatment of intractable occipital neuralgia: technical feasibility and preliminary results

Abstract

Background The treatment algorithm for occipital neuralgia follows the ladder principle. For intractable occipital neuralgia, C2 ganglionectomy can be an effective treatment option. Advancements in percutaneous endoscopic spinal surgery make it possible to accomplish C2 ganglionectomy using a full-endoscopic uniportal surgical technique. Methods From March 2020 to April 2021, three consecutive patients with intractable occipital neuralgia underwent percutaneous full-endoscopic C2 ganglionectomy. All the patients were followed up for more than 12 months. Previous treatment measures, operative time, blood loss, length of hospital stay, and complications were recorded. Finally, the visual analog score (VAS) and Headache Disability Inventory (HDI) were utilized to evaluate surgical efficacy. Results All the patients were successfully treated with a percutaneous full-endoscopic C2 ganglionectomy. Both the postoperative VAS scores and the HDI scores improved after C2 ganglionectomy in the three patients. There was no CSF leakage, incision infection, neck deformity, or other complications. Conclusions Patients suffering from intractable occipital neuralgia may benefit from percutaneous endoscopic C2 ganglionectomy, which possesses several advantages such as excellent visualization and reducing surgery-related trauma, blood loss, and length of stay.