Treatment of Cervicogenic Headache Concurrent With Cervical Stenosis by Anterior Cervical Decompression and Fusion

Abstract

Study design: Retrospective study.

Objective: To report the efficacy of anterior cervical decompression and fusion surgery as treatment method for cervicogenic headache (CeH).

Summary of background data: The exact diagnostic criteria and optimal treatment of CeH is still under investigation.

Methods: A total of 34 consecutive patients (mean age 55.8 y) with CeH (in addition to cervical stenosis symptomatology) resistant to nonoperative treatment were treated by anterior cervical decompression and fusion from 1 up to 3 levels and were followed for at least 1 year. Clinical visual analog pain scale for headache, patient satisfaction index as well as radiographic examinations (flexion-extension radiographs and, when diagnosis of fusion status was uncertain, computed tomography) were documented for all patients at regular intervals. Statistical comparisons of outcome measures between different time points of examinations were performed.

Results: All patients reported relief of their CeH with mean (range) visual analog pain scale scores as 8.1 (3-9), 2.4 (0-4), and 3.1 (0-5) preoperatively, at 2 months postoperatively, and at the final follow-up, respectively. There was a significant improvement (P<0.001) of visual analog pain scale score between before surgery and at 2 months postoperatively or at the last follow-up. Thirty patients (88%) reported satisfied with their treatment, whereas 4 patients (12%) were not satisfied with surgery. No major surgical complication was seen and only 1 patient had symptomless pseudoarthrosis.

Conclusions: CeH when associated with cervical spinal stenosis of the subaxial spine can improve when stenosis is treated with anterior cervical discectomy and fusion.