Cervicogenic headache alleviation after cervical coblation nucleoplasty: A prospective cohort study.
A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty.The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches.In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L. Cervicogenic pain was diagnosed according to the International Headache Society criteria. During the 24-month follow-up, pain visual analog scale (VAS) scores were collected as the primary outcomes, and significant pain relief rate, Neck Disability Index (NDI) headache scores, and Patients Satisfaction Index (PSI) scores were recorded as secondary outcomes to evaluate headache severity and physical function postoperatively.During the 24-month follow-up, a significant decrease in headache VAS scores was observed in group C but not in group L. NDI and PSI scores in group C were better than those in group L. In comparison with the final follow-up, no significant differences in the NDI and PSI scores were found in all observations after surgery. In comparison to group L, ≥50% pain relief was significantly better in group C. No serious complications were observed except for ≤20% of ecchymoma at the needle insertion site.This prospective study indicated that cervicogenic headaches may benefit from nucleoplasty.
Department of Pain Management, Xuanwu Hospital, Capital Medical University, Xicheng, Beijing, China.
Liangliang
L
He
Jianning
J
Yue
Liqiang
L
Yang
Baishan
B
Wu
Guoqing
G
Cao
Yuna
Y
Guo
Guanghui
G
Lai
Yuanzhang
Y
Tang
Jiaxiang
J
Ni
D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D051298:Post-Traumatic Headache / Q000601:surgery*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020069:Shoulder Pain / Q000601:surgery*
Pain Pract. 2010 Mar-Apr;10(2):124-30
20415729
Pain Manag. 2012 May;2(3):191-4
24654659
Headache. 2010 Apr;50(4):699-705
20456156
Cephalalgia. 2008 Jul;28 Suppl 1:41-4
18494997
Pain Physician. 2004 Jan;7(1):115-8
16868623
Spine (Phila Pa 1976). 1995 Sep 1;20(17):1884-8
8560336
Spine J. 2005 Jul-Aug;5(4):381-8
15996607
Acta Neurol Scand. 2008 Mar;117(3):173-80
18031563
Clin Spine Surg. 2017 Oct;30(8):E1093-E1097
28937465
Spine (Phila Pa 1976). 2002 Oct 15;27(20):2240-4
12394901
Pain Physician. 2014 Mar-Apr;17(2):E149-73
24658486
Cephalalgia. 1983 Dec;3(4):249-56
6640659
J Bone Joint Surg Am. 1958 Jun;40-A(3):607-24
13539086
Acta Neurol Scand. 2007 Mar;115(3):185-91
17295714
Curr Pain Headache Rep. 2015 May;19(5):484
25795156
Headache. 2015 Feb;55 Suppl 1:59-71
25644836
J Neurosurg Spine. 2014 Aug;21(2):217-22
24836655
J Neurosurg. 1958 Nov;15(6):602-17
13599052
Medicine (Baltimore). 2015 May;94(20):e858
25997062
Spine (Phila Pa 1976). 1996 Feb 1;21(3):300-11; discussion 311-2
8742205
Cephalalgia. 2007 Sep;27(9):1050-4
17680818
Cephalalgia. 2004;24 Suppl 1:9-160
14979299
Spine (Phila Pa 1976). 2012 Jul 15;37(16):1357-62
22310098
Cephalalgia. 2010 Dec;30(12):1468-76
20974607