Peripheral Occipital Nerve Decompression Surgery in Migraine Headache

Background The therapeutic benefit of nerve decompression surgeries for chronic headache/migraine are controversial. Aim To provide clinical characteristics of headache type and treatment outcome of occipital nerve decompression surgery. Methods A retrospective review of clinical records. Inclusion criteria were evidence of chronic occipital headache with and without migrainous features and tenderness of neck muscles, occipital allodynia, and inadequate response to prophylactic drugs. Results Surgical decompression of the greater and lesser occipital nerves provided complete and extended (3–6 years) relief of new daily persistent headache in case 3 (46 year old female), and of chronic post-traumatic headache in cases 4 and 6 (35 and 30 year old females, respectively), partial relief of chronic headache/migraine in cases 1 and 2 (41 year old female and 36 year old male), and no relief of episodic (cases 3 and 4) or chronic migraine (case 5, 52 year old male), or chronic tension-type headache (case 7, 31 year old male). Conclusions As a case series, this study cannot test a hypothesis or determine cause and effect. However, the complete elimination of new daily persistent headache and post-traumatic headache, and the partial elimination of chronic headache/migraine in two patients – all refractory to other treatment approaches – supports and justifies the effort to continue to generate data that can help determine whether decompression nerve surgeries are beneficial in the treatment of certain types of chronic headache.

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The 36-Item Short-Form Health Survey Outcome Evaluation for Multiple Lower-Extremity Nerve Decompressions in Diabetic Peripheral Neuropathy

Journal of the American Podiatric Medical Association ◽

10.7547/0970121 ◽

2007 ◽

Vol 97 (2) ◽

pp. 121-125 ◽

Cited By ~ 7

Author(s):

Scott C. Nelson ◽

Eugene R. Little

Keyword(s):

Lower Extremity ◽

Diabetic Neuropathy ◽

Health Survey ◽

Short Form ◽

Decompression Surgery ◽

Short Form Health Survey ◽

Nerve Decompression ◽

Form Health ◽

Nerve Decompression Surgery ◽

Short Form Health

Background: Diabetic neuropathy can be disabling owing to pain and loss of sensibility. Theoretically, surgical restoration of sensation and relief of pain may prevent these complications and improve quality of life. A study was conducted to perform outcome analysis of patients after these surgical procedures using the 36-Item Short-Form Health Survey. Methods: The 36-Item Short-Form Health Survey was used to evaluate patients with diabetic neuropathy after nerve decompression surgery. These results were compared with those reported in the literature related to diabetic patients without neuropathy, patients with low-back pain, and an age-matched normative population. The pilot study group included six patients with diabetic neuropathy, three of whom underwent multiple nerve decompression surgery bilaterally. Mean follow-up was 6 months. Results: Single-tailed t tests demonstrated that postoperative patients were not statistically significantly different from the other groups in the domains of Physical Functioning, Bodily Pain, General Health, Vitality, Social Functioning, and Mental Health; in the domains of Role-Physical and Role-Emotional, a statistically significant difference was found, with the postoperative patients scoring lower. Conclusions: Although this study is limited by the lack of preoperative administration of the 36-Item Short-Form Health Survey and by its small sample size, we conclude that the survey can evaluate the results of surgical decompression of lower-extremity peripheral nerves and should be added to the traditional assessments of recovery of sensibility and the visual analog scale for pain. (J Am Podiatr Med Assoc 97(2): 121–125, 2007)

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