Revisiting the Role of Occipital Artery Resection in Greater Occipital Nerve Decompression.

Overview

abstract

INTRODUCTION: Greater occipital nerve (GON) surgery has been shown to improve headaches caused by nerve compression. There is a paucity in data, however, specifically regarding the efficacy of concomitant occipital artery resection. To that end, the goal of this study was to compare the efficacy of greater occipital nerve decompression with and without occipital artery resection. METHODS: This multi-center retrospective cohort study consisted of two groups: the occipital artery resection group (the artery was identified and resected) and the control group (no occipital artery resection). Preoperative, 3 months' and 12 months' migraine frequency, duration, intensity, Migraine Headache Index (MHI), and complications were extracted and analyzed. RESULTS: A total of 94 patients underwent GON decompression and met all inclusion criteria, with 78 in the occipital artery resection group and 16 in the control group. Both groups did not differ in any of the demographic factors or preoperative migraine frequency, duration, intensity or MHI. Postoperatively, both groups demonstrated a significant decrease in migraine frequency, duration, intensity, and MHI. The decrease in MHI was significantly greater amongst the occipital artery resection group than the control group (p=0.019). Both groups had no major complications and a very low rate of minor complications. CONCLUSION: Occipital artery resection during greater occipital nerve decompressions is safe and improves outcomes, therefore it should be performed routinely.