Occipital Neuralgia When Surgical and Ablative Procedures Have Not Achieved Adequate Pain Relief
This protocol applies to patients with occipital neuralgia in whom an escalating series of surgical and ablative interventions has been completed without reaching the target level of symptom control.
Patients have previously undergone one or more of the following: radiofrequency ablation of the occipital nerve, surgical neurolysis of the greater occipital nerve, cervical dorsal rhizotomy, or peripheral neurectomy. Despite these interventions, more than 50% relief of occipital pain was not achieved, warranting progression to a further step.
When all prior modalities have been exhausted, the protocol outlines a more definitive surgical approach directed at the nerve cell bodies themselves — going beyond the peripheral procedures that preceded it. The complete structured regimen, including patient-selection criteria and procedural guidance, is available via the link below.
References
- C2 ganglionectomy can be considered as a last resort when all the other modalities fail to provide relief.
- Hence, C2 dorsl root ganglion (DRG) excision is considered to be a more definitive solution to neurectomy, as the cell bodies residing in the C2 ganglion are excised completely, thereby annulling the scope of regeneration.