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  • adviceonce
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    Post count: 3

    Hello I got strangled in a abusive situation. And ever since I been getting severe bad headaches that start from the neck and into the back of the head, muscle spasms on scalp, and forehead pain. They diagnosed me with mild spondylosis and mild reversal lordotic curvature. Do you think I will need surgery to fix my headache?

    Here are my mri on my cervical spine btw.

    FINDINGS:

    There is mild reversal of cervical lordotic curvature. No scoliosis. No vertebral body subluxation or acute fracture. No scoliosis. Vertebral body height is maintained. No fracture or dislocation identified.

    Mild intervertebral disc degenerative changes with decreased hydration and height. No significant degenerative facet arthropathy or ligamentum flavum hypertrophy is present.

    No disc herniation or significant spinal canal or neuroforaminal narrowing in any of the cervical spine levels.

    The cervical spinal cord is normal in caliber and signal intensity.

    The paravertebral soft tissues are unremarkable.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    I’m truly sorry to hear that you were strangled in a abusive situation. I hope you are out of that and can move on safely. Upper cervical facet damage is just one of the possibilities for generation of cervicogenic headaches. If your headaches seem to be generated in the base of your skull and radiate upwards, facet injury is one of the differentials.

    On examination, your physician should be able to precipitate or aggravate the headache by deep palpation of the upper cervical facets. The X-rays generally should show no significance signs of instability but may demonstrate facet arthritis. MRI may be clean but may show bony inflammation of the joints.

    If there is evidence of facet origin of headache, then diagnostic facet block(s) would be in order. If positive, facet ablations would be the next step (RFAs).

    See:
    https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/
    https://neckandback.com/conditions/cervical-degenerative-facet-disease/

    Dr. Corenman

    adviceonce
    Participant
    Post count: 3

    Thank you for your reply. So surgery would not be a option to get rid of the headache? Only facet block. And if I damaged my facets can nerve decompression help with that?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Radio-frequency ablation (RFA) is a non-surgical technique to “kill the nerve” that sends pain signals from the damaged facet which can eliminate headaches. Another term is “rhizotomy”. It is performed in an outpatient setting.

    Dr. Corenman

    adviceonce
    Participant
    Post count: 3

    Yes I know about that. But I am not sure if my insurance covers it. I know they cover nerve decompression surgery. Do you think nerve decompression surgery would work as well?

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