{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:01:14Z","timestamp":1760299274144},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Occipital neuralgia (ON) causes chronic pain in the cutaneous distribution of the greater and lesser occipital nerves. The long-term efficacy of cervical dorsal root rhizotomy (CDR) in the management of ON has not been well described. The authors reviewed their 14-year experience with CDR to assess pain relief and functional outcomes in patients with medically refractory ON.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A retrospective chart review of 75 ON patients who underwent cervical dorsal root rhizotomy, from 1998 to 2012, was performed. Fifty-five patients were included because they met the International Headache Society's (IHS) diagnostic criteria for ON, responded to CT-guided nerve blocks at the C-2 dorsal nerve root, and had at least one follow-up visit. Telephone interviews were additionally used to obtain data on patient satisfaction.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Forty-two patients (76%) were female, and the average age at surgery was 46 years (range 16\u201380). Average follow up was 67 months (range 5\u2013150). Etiologies of ON included the following: idiopathic (44%), posttraumatic (27%), postsurgical (22%), post\u2013cerebrovascular accident (4%), postherpetic (2%), and postviral (2%). At last follow-up, 35 patients (64%) reported full pain relief, 11 (20%) partial relief, and 7 (16%) no pain relief. The extent of pain relief after CDR was not significantly associated with ON etiology (p = 0.43). Of 37 patients whose satisfaction-related data were obtained, 25 (68%) reported willingness to undergo repeat surgery for similar pain relief, while 11 (30%) reported no such willingness; a single patient (2%) did not answer this question. Twenty-one individuals (57%) reported that their activity level\/functional state improved after surgery, 5 (13%) reported a decline, and 11 (30%) reported no difference. The most common acute postoperative complications were infections in 9% (n = 5) and CSF leaks in 5% (n = 3); chronic complications included neck pain\/stiffness in 16% (n = 9) and upper-extremity symptoms in 5% (n = 3) such as trapezius weakness, shoulder pain, and arm paresthesias.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Cervical dorsal root rhizotomy provides an efficacious means for pain relief in patients with medically refractory ON. In the appropriately selected patient, it may lead to optimal outcomes with a relatively low risk of complications.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.6.jns142772","type":"journal-article","created":{"date-parts":[[2015,12,18]],"date-time":"2015-12-18T15:43:20Z","timestamp":1450453400000},"page":"102-110","source":"Crossref","is-referenced-by-count":11,"title":["Long-term outcomes of intradural cervical dorsal root rhizotomy for refractory occipital neuralgia"],"prefix":"10.3171","volume":"125","author":[{"given":"Abhiram V.","family":"Gande","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine;\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas","family":"Chivukula","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine;\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Moossy","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Rothfus","sequence":"additional","affiliation":[{"name":"Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns142772","series-title":"Neurol Neurochir Pol","first-page":"871","article-title":"[Occipital nerve neuralgia as postoperative complication. 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