Doctors at the University Hospital of Bordeaux Spinal Unit in France report on a new operation. They treated 10 patients for a problem called greater occipital neuralgia (GON). Neuralgia is a term that means "nerve pain." Greater occipital refers to a nerve in the back of the head and neck.
The cause of GON isn't always known. There isn't much room for the nerve because of its location between the skull and the soft tissues. It also passes through some joints and muscles, which can put a stretch on the nerve. In these 10 patients, three who had anatomic changes of different kinds causing the problem.
The operation released pressure on the nerve. The doctors detached the inferior oblique muscle from its attachment to the cervical spine. They also released part of the nerve. Both of these techniques relax the nerve and loosen the stretch.
Three measures were used to judge the results of this operation: pain level, use of pain medicine, and patient satisfaction. The authors report that everyone had relief of pain. Seven patients were happy with the results.
GON is hard to treat. It often becomes a chronic problem or comes back after treatment with drugs or by cutting the nerve. The authors conclude that this new surgical treatment works well for some, but not all, patients. Patients who got the best results usually had been dealing with the problem for more than one year. They tended to have more pain when bending their head. And their pain went away for a short time when injected with numbing medication, such as lidocaine.