Cervicogenic headache treatment [Neurosurgery Wiki]

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====== Cervicogenic headache treatment ======

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Previous clinical studies found that anterior lower [[cervical discectomy]] for the [[degenerative cervical myelopathy treatment]] and/or [[cervical radiculopathy]] can also help relieve associated [[headache]]s. To date, there is still a lack of a large sample and [[prospective]] study to investigate the effect of [[anterior cervical decompression and fusion]] (ACDF) on CEH associated with [[cervical spondylosis]].

A total of 656 patients with [[cervical radiculopathy]] and/or [[degenerative cervical myelopathy]] were enrolled in three [[spinal]] [[center]]s. Among them, 221 patients who were diagnosed with CEH were collected in this study, and 204 completed a 1-year follow-up. The primary endpoint was headache intensity during a 12-month follow-up period measured by the numeric pain rating scale (NPRS). The secondary outcome measures included headache frequency, headache duration, and the [[neck disability index]] (NDI).

Among all 204 patients with CEH who completed a 1-year follow-up, 166 received anterior cervical surgery (surgery group), and 38 received [[conservative treatment]] (conservative group). There were statistically significant lower NPRS in the surgical group during follow-up. Between-group differences showed that NPRS in the surgery group was significantly greater improvement at 1 month (2.8, 95% CI: 2.0, 3.6), 3 months (2.6, 95% CI: 1.8, 3.4), 6 months (2.4, 95% CI: 1.6, 3.2), and 12 months (1.5, 95% CI: 0.7, 2.4) (p < 0.05 for all). There were statistically significant lower NDI, less frequent headaches, and lower headache duration in the surgery group during follow-up (p < 0.05 for all).

This study indicates that ACDF can effectively relieve CEH associated with [[cervical myelopathy]] and/or [[radiculopathy]]
((Yang L, Li Y, Dai C, Pang X, Li D, Wu Y, Chen X, Peng B. Anterior cervical decompression and fusion surgery for cervicogenic headache: A multicenter prospective cohort study. Front Neurol. 2022 Nov 24;13:1064976. doi: 10.3389/fneur.2022.1064976. PMID: 36504652; PMCID: PMC9731211.)).