Resolution of Severe Cervicogenic Headache after Cervical Open-Door Laminoplasty

Abstract

The optimal treatment strategy for cervicogenic headache (CeH) remains controversial, possibly because the pathophysiology of this disease entity is unclear. The present study describes a case of alleviation of severe CeH that was alleviated after cervical open-door laminoplasty and reviews magnetic resonance imaging (MRI) data from a series of patients with CeH. In our case study, a 63-year-old male with severe headache underwent cervical open-door laminoplasty and his headache resolved postoperatively. In our MRI review, since preoperative MRI showed moderate, not severe, compression of the spinal cord by the surrounding tissues (bones, discs, and ligaments), the relationship between the degree of cervical spondylosis and headache was analyzed in patients with cervical spondylosis who were identified between November 2005 and December 2006 in the Department of Neurosurgery of our hospital. MRI data was compared between patients with and without headache. The number of cervical spinal levels in which there was either moderate or severe compression was significantly greater in the group without headache (at least 4 levels) than in the group with headache (at most 3 levels), All patients with pain who subsequently underwent open-door laminoplasty experienced alleviation of their symptoms. These data suggest that moderate cervical spondylosis may result in CeH and that cervical open-door laminectomy may be an effective therapeutic modality for treating this phenomenon.