Surgery for Cervical Spine Disorders Alleviates Associated Headaches

A new study has found that two years after anterior cervical neck operations, patients who have arthroplasty or arthrodesis (spine fusion) procedures can be expected to have significant improvement in their headache symptoms.

Researchers at Orthopaedics Indianapolis (IN, USA) conducted a post-hoc analysis of study cohorts combined from prospective studies comparing the results of Prestige and Bryan cervical arthroplasty devices and those of anterior cervical arthrodesis with allograft and anterior instrumentation. A total of 1,004 patients (51.6% male) were evaluated with use of the Neck Disability Index (NDI) questionnaire preoperatively and at five points postoperatively, with the latest evaluation at twenty-four months, resulting in a follow-up of 803 patients. None of the patients surveyed had their operation to treat their headaches, and headaches were not their only complaint. Additionally, no significant difference was reported in headache severity between the arthroplasty and arthodesis groups.

The researcher found that at the twenty-four-month follow-up, the improvement from baseline with regard to headache was significant in both groups, with patients who underwent arthroplasty reporting numerically better pain scores. Most arthroplasty and arthrodesis patients had improvement in the pain score of at least one grade. Conversely, the pain scores for 8.4% of those who had an arthroplasty and 13.7% of those who had arthrodesis worsened by at least one grade. For the remainder, the score was unchanged. Overall, the patients who had an arthroplasty had significant improvement more frequently than did the patients who had arthrodesis. The study was published in the August 2009 issue of The Journal of Bone and Joint Surgery (JBJS).

"This is not a 'cure' for all headaches. But, if you have headaches associated with neck pain and dysfunction, surgery for the neck problem can significantly improve the related headaches,” said lead author, Joseph Riina, M.D. "And any time overall quality of life can be improved with surgical treatment, that is something to note.”

The study did not include migraine headaches, and only studied headaches associated with cervical spine disease. Additionally, the study authors acknowledged there still is a lack of knowledge regarding the exact anatomical structures that cause headaches, which could be caused by the disc, joints, muscles, tissues, or some combination of all of those.

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