Anterior Cervical Surgery for the Treatment of Cervicogenic Headache Caused by Cervical Spondylosis

Study Design: Retrospective study. Objective: To report the efficacy of anterior cervical surgery for the relief of cervicogenic headache (CEH) caused by cervical spondylosis. Methods: From January 2014 to December 2016, a total of 166 cases of cervical radiculopathy and/or myelopathy received anterior cervical decompression and fusion (ACDF) in our institution, among which 50 cases (mean age 44.7 years) were accompanied by CEH and followed up at 3, 6, 12, and 24 months postoperatively, respectively. Neck pain and headache scores according to neck disability index (NDI) were documented for all patients at regular intervals. The results measured at different follow-up time point were compared statistically. Results: All 50 patients reported neck pain and headache at the same time before surgery. The average NDIs for neck pain before and after surgery were 2.86 (95% CI: 2.7– 3.0) preoperatively, 0.98 (95% CI: 0.8– 1.1) at 3 months, 0.68 (95% CI: 0.5– 0.9) at 6 months, 0.62 (95% CI: 0.5– 0.8) at 12 months, and 0.60 (95% CI: 0.4– 0.8) at 24 months postoperatively, respectively. The average NDIs for CEH before and after surgery were 2.32 (95% CI: 2.2– 2.5) preoperatively, 0.62 (95% CI: 0.5– 0.8) at 3 months, 0.60 (95% CI: 0.4– 0.8) at 6 months, 0.56 (95% CI: 0.4– 0.7) at 12 months, and 0.50 (95% CI: 0.3– 0.7) at 24 months postoperatively, respectively. The neck pain and headache improved in all cases and the NDI score of neck pain or headache at each follow-up point after surgery was significantly different from that before surgery (P < 0.001). The simple correlation analysis between neck pain and headache was performed, and the Pearson coefficient r was 0.71, indicating a positive correlation between neck pain NDI and headache NDI. No serious surgical complications were found. Conclusion: Our study suggests that patients with cervical spondylosis complicated with CEH are always accompanied by neck pain. ACDF can not only relieve neck pain but also improve the accompanying CEH. Keywords: cervicogenic headache, neck pain, cervical spondylosis, anterior cervical decompression and fusion