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

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.