Skip to main content
Top
Published in: Neuroradiology 12/2005

01-12-2005 | Interventional Neuroradiology

Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation

Authors: Y. Ahn, S. H. Lee, S. E. Chung, H. S. Park, S. W. Shin

Published in: Neuroradiology | Issue 12/2005

Login to get access

Abstract

A discogenic cervical headache is a subtype of cervicogenic headache (CEH) that arises from a degenerative cervical disc abnormality. The purpose of this study was to evaluate the clinical outcome of percutaneous endoscopic cervical discectomy (PECD) for patients with chronic cervical headache due to soft cervical disc herniation. Seventeen patients underwent PECD for intractable headache. The inclusion criteria were soft disc herniation without segmental instability, proven by both local anesthesia and provocative discography for headache unresponsive to conservative treatment. The mean follow-up period was 37.6 months. Fifteen of the 17 patients (88.2%) showed successful outcomes based on the Macnab criteria. Pain scores on a visual analog scale (VAS) improved from a preoperative mean of 8.35±0.79 to 2.12±1.17, postoperatively (P<0.01). The mean disc height decreased from 6.81±1.08 to 5.98±1.07 mm (P<0.01). There was no newly developed segmental instability or spontaneous fusion on follow-up radiography. In conclusion, PECD appears to be effective for chronic severe discogenic cervical headache under strict inclusion criteria.
Literature
1.
go back to reference Sjaastad O, Saunte C, Hovdahl H, Breivik H, Gronbaek E (1983) “Cervicogenic” headache. An hypothesis. Cephalalgia 3:249–256CrossRef Sjaastad O, Saunte C, Hovdahl H, Breivik H, Gronbaek E (1983) “Cervicogenic” headache. An hypothesis. Cephalalgia 3:249–256CrossRef
2.
go back to reference Blume HG (2000) Cervicogenic headaches: radiofrequency neurotomy and the cervical disc and fusion. Clin Exp Rheumatol 18:S53–S58 Blume HG (2000) Cervicogenic headaches: radiofrequency neurotomy and the cervical disc and fusion. Clin Exp Rheumatol 18:S53–S58
3.
go back to reference Bogduk N, Windsor M, Inglis A (1988) The innervation of the cervical intervertebral discs. Spine 13:2–8PubMed Bogduk N, Windsor M, Inglis A (1988) The innervation of the cervical intervertebral discs. Spine 13:2–8PubMed
4.
go back to reference Bovim G, Fredriksen TA, Stolt-Nielsen A, Sjaastad O (1992) Neurolysis of the greater occipital nerve in cervicogenic headache. A follow up study. Headache 32:175–179CrossRef Bovim G, Fredriksen TA, Stolt-Nielsen A, Sjaastad O (1992) Neurolysis of the greater occipital nerve in cervicogenic headache. A follow up study. Headache 32:175–179CrossRef
5.
go back to reference Hildebrandt J, Jansen J (1984) Vascular compression of the C2 and C3 roots—yet another cause of chronic intermittent hemicrania? Cephalalgia 4:167–170CrossRefPubMed Hildebrandt J, Jansen J (1984) Vascular compression of the C2 and C3 roots—yet another cause of chronic intermittent hemicrania? Cephalalgia 4:167–170CrossRefPubMed
6.
go back to reference Schellhas KP, Smith MD, Gundry CR, Pollei SR (1996) Cervical discogenic pain Prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine 21:300–311CrossRefPubMed Schellhas KP, Smith MD, Gundry CR, Pollei SR (1996) Cervical discogenic pain Prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine 21:300–311CrossRefPubMed
7.
go back to reference Schellhas KP, Garvey TA, Johnson BA, Rothbart PJ, Pollei SR (2000) Cervical diskography: analysis of provoked responses at C2–C3, C3–C4, and C4–C5. AJNR Am J Neuroradiol 21:269–275PubMed Schellhas KP, Garvey TA, Johnson BA, Rothbart PJ, Pollei SR (2000) Cervical diskography: analysis of provoked responses at C2–C3, C3–C4, and C4–C5. AJNR Am J Neuroradiol 21:269–275PubMed
8.
go back to reference Schofferman J, Garges K, Goldthwaite N, Koestler M, Libby E (2002) Upper cervical anterior diskectomy and fusion improves discogenic cervical headaches. Spine 27:2240–2244CrossRefPubMed Schofferman J, Garges K, Goldthwaite N, Koestler M, Libby E (2002) Upper cervical anterior diskectomy and fusion improves discogenic cervical headaches. Spine 27:2240–2244CrossRefPubMed
9.
go back to reference Lord SM, Barnsley L, Wallis BJ, Bogduk N (1994) Third occipital nerve headache: a prevalence study. J Neurol Neurosurg Psychiatry 57:1187–1190PubMed Lord SM, Barnsley L, Wallis BJ, Bogduk N (1994) Third occipital nerve headache: a prevalence study. J Neurol Neurosurg Psychiatry 57:1187–1190PubMed
10.
go back to reference Fredriksen TA, Salvesen R, Stolt-Nielsen A, Sjaastad O (1999) Cervicogenic headache: long-term postoperative follow-up. Cephalalgia 19:897–900CrossRefPubMed Fredriksen TA, Salvesen R, Stolt-Nielsen A, Sjaastad O (1999) Cervicogenic headache: long-term postoperative follow-up. Cephalalgia 19:897–900CrossRefPubMed
11.
go back to reference Fredriksen TA, Stolt-Nielsen A, Skaanes KO, Sjaastad O (2003) Headache and the lower cervical spine: long-term, postoperative follow-up after decompressive neck surgery. Funct Neurol 18:17–28PubMed Fredriksen TA, Stolt-Nielsen A, Skaanes KO, Sjaastad O (2003) Headache and the lower cervical spine: long-term, postoperative follow-up after decompressive neck surgery. Funct Neurol 18:17–28PubMed
12.
go back to reference Michler RP, Bovim G, Sjaastad O (1991) Disorders in the lower cervical spine. A cause of unilateral headache? A case report. Headache 31:550–551 Michler RP, Bovim G, Sjaastad O (1991) Disorders in the lower cervical spine. A cause of unilateral headache? A case report. Headache 31:550–551
13.
go back to reference Jansen J (2000) Surgical treatment of non-responsive cervicogenic headache. Clin Exp Rheumatol 18:S67–S70PubMed Jansen J (2000) Surgical treatment of non-responsive cervicogenic headache. Clin Exp Rheumatol 18:S67–S70PubMed
14.
go back to reference Ahn Y, Lee SH, Lee SC, Shin SW, Chung SE (2004) Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Neuroradiology 46:378–384CrossRefPubMed Ahn Y, Lee SH, Lee SC, Shin SW, Chung SE (2004) Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Neuroradiology 46:378–384CrossRefPubMed
15.
go back to reference Chiu JC, Clifford TJ, Greenspan M, Richley RC, Lohman G, Sison RB (2000) Percutaneous microdecompressive endoscopic cervical discectomy with laser thermodiskoplasty. Mt Sinai J Med 67:278–282PubMed Chiu JC, Clifford TJ, Greenspan M, Richley RC, Lohman G, Sison RB (2000) Percutaneous microdecompressive endoscopic cervical discectomy with laser thermodiskoplasty. Mt Sinai J Med 67:278–282PubMed
16.
go back to reference Knight MT, Goswami A, Patko JT (2001) Cervical percutaneous laser disc decompression: preliminary results of an ongoing prospective outcome study. J Clin Laser Med Surg 19:3–8CrossRefPubMed Knight MT, Goswami A, Patko JT (2001) Cervical percutaneous laser disc decompression: preliminary results of an ongoing prospective outcome study. J Clin Laser Med Surg 19:3–8CrossRefPubMed
17.
go back to reference Sjaastad O, Fredriksen TA, Pfaffenrath V (1998) Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International Study Group. Headache 38:442–445CrossRefPubMed Sjaastad O, Fredriksen TA, Pfaffenrath V (1998) Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International Study Group. Headache 38:442–445CrossRefPubMed
18.
go back to reference Macnab I (1971) Negative disc exploration An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am 53:891–903PubMed Macnab I (1971) Negative disc exploration An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am 53:891–903PubMed
19.
go back to reference Anthony M (2000) Cervicogenic headache: prevalence and response to local steroid therapy. Clin Exp Rheumatol 18:S59–S64PubMed Anthony M (2000) Cervicogenic headache: prevalence and response to local steroid therapy. Clin Exp Rheumatol 18:S59–S64PubMed
20.
21.
go back to reference Coskun O, Ucler S, Karakurum B, Atasoy HT, Yildirim T, Ozkan S, et al (2003) Magnetic resonance imaging of patients with cervicogenic headache. Cephalalgia 23:842–845CrossRefPubMed Coskun O, Ucler S, Karakurum B, Atasoy HT, Yildirim T, Ozkan S, et al (2003) Magnetic resonance imaging of patients with cervicogenic headache. Cephalalgia 23:842–845CrossRefPubMed
22.
go back to reference Fredriksen TA, Fougner R, Tangerud A, Sjaastad O (1989) Cervicogenic headache Radiological investigations concerning head/neck. Cephalalgia 9:139–146CrossRefPubMed Fredriksen TA, Fougner R, Tangerud A, Sjaastad O (1989) Cervicogenic headache Radiological investigations concerning head/neck. Cephalalgia 9:139–146CrossRefPubMed
23.
go back to reference Pfaffenrath V, Dandekar R, Pollmann W (1987) Cervicogenic headache—the clinical picture, radiological findings and hypotheses on its pathophysiology. Headache 27:495–499CrossRefPubMed Pfaffenrath V, Dandekar R, Pollmann W (1987) Cervicogenic headache—the clinical picture, radiological findings and hypotheses on its pathophysiology. Headache 27:495–499CrossRefPubMed
24.
go back to reference Vincent MB, Luna RA (1999) Cervicogenic headache: a comparison with migraine and tension-type headache. Cephalalgia 19(Suppl 25):11–16CrossRefPubMed Vincent MB, Luna RA (1999) Cervicogenic headache: a comparison with migraine and tension-type headache. Cephalalgia 19(Suppl 25):11–16CrossRefPubMed
25.
26.
go back to reference Bogduk N (1992) The anatomical basis for cervicogenic headache. J Manipulative Physiol Ther 15:67–70PubMed Bogduk N (1992) The anatomical basis for cervicogenic headache. J Manipulative Physiol Ther 15:67–70PubMed
27.
go back to reference Henderson CM, Hennessy RG, Shuey HM Jr, Shackelford EG (1983) Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery 13:504–512PubMed Henderson CM, Hennessy RG, Shuey HM Jr, Shackelford EG (1983) Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery 13:504–512PubMed
28.
go back to reference Lunsford LD, Bissonette DJ, Jannetta PJ, Sheptak PE, Zorub DS (1980) Anterior surgery for cervical disc disease. Part 1: Treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53:1–11PubMed Lunsford LD, Bissonette DJ, Jannetta PJ, Sheptak PE, Zorub DS (1980) Anterior surgery for cervical disc disease. Part 1: Treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53:1–11PubMed
29.
go back to reference Blume HG (1998) Treatment of cervicogenic headaches: radiofrequency neurotomy to the sinuvertebral nerves to the upper cervical disc and to the outer layer of the C3 nerve root or C4 nerve root, respectively. Funct Neurol 13:83–84PubMed Blume HG (1998) Treatment of cervicogenic headaches: radiofrequency neurotomy to the sinuvertebral nerves to the upper cervical disc and to the outer layer of the C3 nerve root or C4 nerve root, respectively. Funct Neurol 13:83–84PubMed
30.
go back to reference Sjaastad O, Stolt-Nielsen A, Blume H, Zwart JA, Fredriksen TA (1995) Cervicogenic headache Long-term results of radiofrequency treatment of the planum nuchale. Funct Neurol 10:265–271PubMed Sjaastad O, Stolt-Nielsen A, Blume H, Zwart JA, Fredriksen TA (1995) Cervicogenic headache Long-term results of radiofrequency treatment of the planum nuchale. Funct Neurol 10:265–271PubMed
31.
go back to reference van Suijlekom HA, van Kleef M, Barendse GA, Sluijter ME, Sjaastad O, Weber WE (1998) Radiofrequency cervical zygapophyseal joint neurotomy for cervicogenic headache: a prospective study of 15 patients. Funct Neurol 13:297–303PubMed van Suijlekom HA, van Kleef M, Barendse GA, Sluijter ME, Sjaastad O, Weber WE (1998) Radiofrequency cervical zygapophyseal joint neurotomy for cervicogenic headache: a prospective study of 15 patients. Funct Neurol 13:297–303PubMed
32.
go back to reference Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O’Brien J, Jayson MI (1997) Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet 350:178–181CrossRefPubMed Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O’Brien J, Jayson MI (1997) Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet 350:178–181CrossRefPubMed
Metadata
Title
Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation
Authors
Y. Ahn
S. H. Lee
S. E. Chung
H. S. Park
S. W. Shin
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 12/2005
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-005-1436-y

Other articles of this Issue 12/2005

Neuroradiology 12/2005 Go to the issue

Diagnostic Neuroradiology

Lyme disease of the brainstem