Purpose of Technology

Both local injection therapies and neurosurgery are used in the treatment of cervicogenic headache and occipital neuralgia, which are typically unilateral headaches that may be symptomatic of pathology involving the greater or lesser occipital nerves, or the cervical spine. The goal of injection therapy is to deliver local anesthetic, steroids, or agents such as botulinum toxin into the region of the affected nerve(s) and thereby reduce pain and inflammation. The goal of neurosurgery is to relieve impingement of the nerve root(s) and thereby eliminate symptoms caused by compression and injury of the cervical nerves.

Questions addressed in this report include:

• Do local injection therapies and neurosurgery relieve cervicogenic headache and/or occipital neuralgia?
• Are injection therapies and neurosurgery for cervicogenic headache and occipital neuralgia safe?
• For which patients may injection therapies and neurosurgery provide a benefit?

These questions provide a framework for review and synthesis of the best available evidence, which is presented in this report, along with the Hayes Ratings for the technology. This report also provides background information about the condition being treated, a description of the technology, and the context for development of the technology. Other key elements addressed in the report include the regulatory status; applicable Medicare and commercial payer coverage policies; relevant ICD-9 and ICD-10 diagnosis codes; cost and cost effectiveness; credentialing; hospital length of stay; need for large case management; and ongoing and future clinical trials of the technology.

Posted in Directory Reports
This entry was posted on Friday, September 30th, 2011 at 8:55 am.