Surgical treatment of cervicogenic headache

In the present work, the late results of operative treatment on 60 patients, suffering from long lasting severe unilateral (n = 32) or bilateral (n = 28) cervicogenic headache, non-responsive to other treatment options, will be summarized. Cervicogenic headache (CEH) was diagnosed according to 'The Cervicogenic Headache International Study Group' guidelines. The cervical levels of affection were determined by neurological examination, magnetic resonance imaging (MRI), computed tomography (CT), anaesthetic blockades and X-ray diagnostics. The levels mainly operated on were at the C4/5, C5/6 and C6/7; one or two discs were removed. Immediately postoperatively there was pain freedom. Sixty-three per cent of the unilateral and 64% of the bilateral cases enjoyed long lasting pain freedom or improvement (> 50%). The mean observation time was 19.8 and 25.5 months, respectively. After secondary deterioration (in 37% of patients with unilateral and in 36% with bilateral CEH) and further treatments, the final mean improvement was 73% and 66%, respectively. Well-selected CEH patients may benefit from surgical intervention.