Bovim G, Fredriksen T A, Stolt-Nielsen A, Sjaastad O
Department of Neurology, Regionsykehuset, Trondheim University Hospital, Norway.
Headache. 1992 Apr;32(4):175-9. doi: 10.1111/j.1526-4610.1992.hed3204175.x.
Entrapment of the greater occipital nerve (GON) in its peripheral course has been thought to be of possible pathogenic significance in cervicogenic headache. We have performed a "liberation" operation ("neurolysis") of the nerve in the nuchal musculature, with special attention to the trapezius insertion, and the follow-up results in 50 patients are presented. The immediate effect of the operation was quite good, but the pain gradually recurred in the majority (46/50) of the patients. Eventually, all operated patients will probably have recurrence of pain episodes. Nevertheless, most patients claim that the overall disability is less after the operation, and 40% actually want to undergo a new, identical procedure. The justification for doing a second "liberation" operation is clearly less than for a first operation. In our opinion, this operation should not be performed in patients with cervicogenic headache in general. The present study shows that other therapeutic approaches should be searched for in cervicogenic headache.
枕大神经（GON）在其外周走行过程中受到卡压被认为在颈源性头痛中可能具有致病意义。我们对该神经在项部肌肉组织中进行了“松解”手术（“神经松解术”），特别关注了斜方肌附着点，并展示了50例患者的随访结果。手术的即刻效果相当不错，但大多数（46/50）患者的疼痛逐渐复发。最终，所有接受手术的患者可能都会再次出现疼痛发作。然而，大多数患者声称术后总体功能障碍有所减轻，并且40%的患者实际上希望接受新的、相同的手术。进行第二次“松解”手术的理由明显不如第一次手术充分。我们认为，一般情况下颈源性头痛患者不应进行此手术。本研究表明，对于颈源性头痛应寻求其他治疗方法。
