Stechison M T, Mullin B B
Department of Neurosurgery, University of Pittsburgh, PA, USA.
Acta Neurochir (Wien). 1994;131(3-4):236-40. doi: 10.1007/BF01808620.
The surgical treatment of greater occipital neuralgia often involves diagnostic anesthetic blockade, followed by chemical or surgical ablation of the greater occipital nerve. The anatomy of this region was studied in microdissections of 2 cadaver specimens. The diagnosis and management of a series of 5 patients with greater occipital neuralgia is discussed. Two patients were treated with atlanto-epistrophic ligament decompression of the C2 dorsal root ganglion and nerve; four patients had C2 ganglionotomy performed. All patients in this series had immediate complete relief of pain following surgery. Patients were followed for a mean of 24 months (range 7-33 months). One patient had a recurrence of her original pain after 26 months following atlanto-epistrophic ligament decompression and required re-operation in the form of bilateral C2 ganglionotomy. All patients experienced transient nausea and dizziness in the several days following surgery. One patient had an incisional cerebrospinal fluid leak. Microsurgical C2 gangliotomy is advocated as the preferred surgical treatment of greater occipital neuralgia of idiopathic origin.
枕大神经痛的外科治疗通常包括诊断性麻醉阻滞，随后对枕大神经进行化学或手术切除。对2具尸体标本进行显微解剖研究了该区域的解剖结构。讨论了一系列5例枕大神经痛患者的诊断和治疗情况。2例患者接受了C2背根神经节和神经的寰枢椎韧带减压术；4例患者进行了C2神经节切断术。该系列所有患者术后疼痛均立即完全缓解。患者平均随访24个月（范围7 - 33个月）。1例患者在寰枢椎韧带减压术后26个月出现原疼痛复发，需要进行双侧C2神经节切断术再次手术。所有患者在术后数天均出现短暂的恶心和头晕。1例患者出现切口脑脊液漏。显微外科C2神经节切断术被认为是特发性枕大神经痛的首选外科治疗方法。
