title: Transarticular screw fixation of C1-2 for the treatment of arthropathy-associated occipital neuralgia.
abstract: Two patients with occipital neuralgia due to severe arthropathy of the C1-2 facet joint were treated using atlantoaxial fusion with transarticular screws without decompression of the C-2 nerve root. Both patients experienced immediate postoperative relief of occipital neuralgia. The resultant motion elimination at C1-2 eradicated not only the movement-evoked pain, but also the paroxysms of true occipital neuralgia occurring at rest. A possible pathophysiological explanation for this improvement is presented in the context of the ignition theory of neuralgic pain. This represents the first report of C1-2 transarticular screw fixation for the treatment of arthropathy-associated occipital neuralgia.
authors.affiliation: Houston MicroNeurosurgery, Houston, Texas, USA. pakzaban@swbell.net
authors.forename: Peyman
authors.initials: P
authors.lastname: Pakzaban
mesh_terms: D001172:Arthritis, Rheumatoid / Q000601:surgery*; D001268:Atlanto-Axial Joint / Q000473:pathology / Q000601:surgery*; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019547:Neck Pain / Q000601:surgery*; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000601:surgery; D009437:Neuralgia / Q000601:surgery*; D055013:Osteoarthritis, Spine / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery; D025241:Spondylarthritis / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed