Cervicogenic headache: long-term prognosis after neck surgery.
OBJECTIVE
To evaluate the postoperative fate of chronic, hard-to-treat and partly suicidal cervicogenic headache (CEH) patients (n = 32), diagnosed according to the CHISG criteria and treated with a decompression/stabilization operation in the cervical spine: the Smith/Robinson operation.


METHODS
The cervical levels of affection, singled out by magnetic resonance, anaesthetic blockades and X-ray examinations were mainly at the C4-5, C5-6, C6-7 levels; one or two discs were removed. The study was prospective and controlled.


RESULTS
During the 1- to 3-month-long postoperative period of collar-wearing, there generally was pain freedom. The mean time of follow-up was 19.8 months: pain recurrence, known to the authors, appeared after 1-58 months (n = 12). The mean time of improvement was: 14.8 months (range 1-58 months). Five patients stayed well > or =3 years. This is certainly a minimum figure. The patients ultimately were lost to follow-up.


CONCLUSIONS
For the time being, this operation should preferably be used in selected, chronic, severely afflicted, preferably elderly CEH patients, when other therapeutic approaches are exhausted.
Jansen
J
J
Department of Neurosurgery, Georg-August Universität, Göttingen, Germany.
Sjaastad
O
O
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D002908:Chronic Disease; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D051298:Post-Traumatic Headache / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome