Combined third occipital and C3 deep medial branch neurotomy in a patient with C2-3 facet joint osteoarthritis associated cervicogenic headaches: A case report

Kang, Sang Soo; Yi, Young Jin; Yoon, Young Jun; Shin, Keun Man; Yoo, Hong Seong

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2014;9(1):27-30.
Published online January 30, 2014.

Combined third occipital and C3 deep medial branch neurotomy in a patient with C2-3 facet joint osteoarthritis associated cervicogenic headaches: A case report

Sang Soo Kang, Young Jin Yi, Young Jun Yoon, Keun Man Shin, Hong Seong Yoo

¹Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. kssege@naver.com
²Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Ire Pain Clinic, Seoul, Korea.

Received: 27 May 2013 • Revised: 2 July 2013

Abstract

Cervicogenic headache is pain from the head due to various sources in the cervical spine. The C2-3 zygapophysial joints are the most commonly involved structure, and this type of headache could be relieved by blocks or neurotomy of the third occipital nerve. A 59-years-old female patient suffered from cervicogenic headaches due to severe C2-3 zygapophysial joint hypertrophy. Her pain was partially relieved by the third occipital radiofrequency neurotomy, and was almost completely removed by C3 deep medial branch neurotomy. Herein, we report a case of osteoarthritis associated cervicogenic headaches at the C2-3 zygapophysial joints and proposed a treatment option.

Key Words: Cervicogenic headache, Osteoarthritis, Radiofrequency, Zygapophysial joint