Cervicogenic headache treatment

Previous clinical studies found that anterior lower cervical discectomy for the degenerative cervical myelopathy treatment and/or cervical radiculopathy can also help relieve associated headaches. 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 centers. 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 1).

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.
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