Advertisement

The Use of Fat Grafting for Chronic Headache of Cervical Origin Treatment

  • Marco KlingerEmail author
  • Luca Maione
  • Francesco Klinger
  • Silvia Giannasi
Chapter

Abstract

Chronic headache of cervical origin (chronic cervicogenic headache and occipital neuralgia) is characterized by persistent pain due to great occipital nerve entrapment within the trapezoid tunnel, with concurrent myofascial spasm. Symptoms are often impairing, thus influencing everyday activities and decreasing the quality of life. A great number of surgical and nonsurgical options have been proposed even though recurrence rate and failure of the therapy remain considerable. Regenerative surgery might represent in selected cases as an excellent solution especially for recurrent cases as a second-line approach after pharmacological treatment failure. In the present chapter, we report our experience with autologous fat grafting for occipital neuralgia treatment, and we describe the operative technique, outcomes, and future perspectives.

Keywords

Chronic cervical headache Fat grafting Regenerative surgery Migraine Occipital neuralgia 

References

  1. 1.
    Ashkenazi A. Three common neuralgias. Postgrad Med. 2004;116:16–32.CrossRefGoogle Scholar
  2. 2.
    Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009;8:959–68.CrossRefGoogle Scholar
  3. 3.
    Yi X, Cook AJ, Hamill-Ruth RJ, Rowlingson JC. Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis? J Pain. 2005;6:700–3.CrossRefGoogle Scholar
  4. 4.
    Antonaci F, Sjaastad O. Cervicogenic headache: a real headache. Curr Neurol Neurosci Rep. 2011;11:149–55.CrossRefGoogle Scholar
  5. 5.
    Headache Classification Committee. The international classification of headache disorders, 2nd ed. Cephalalgia. 2004;24:8–152.Google Scholar
  6. 6.
    Arnold G. Die örtliche Injecktiosbehandlung okzipitaler und subokzipitaler Schmerzzustände. Munch Med Wochenschr. 1969;111:138–41.PubMedGoogle Scholar
  7. 7.
    Mosser SW, Guyuron B, Janis JE, Rohric RJ. The anatomy of the greater occipital nerve: implications for the etiology of migraine headaches. Plast Reconstr Surg. 2004;113:693–7.CrossRefGoogle Scholar
  8. 8.
    Kuhn WT, Kuhn SC, Gilberstadt H. Occipital neuralgias: clinical recognition of a complicated headache. A case series and literature review. J Orofac Pain. 1997;11:158–65.PubMedGoogle Scholar
  9. 9.
    Dash KS, Janis JE, Guyuron B. The lesser and the third occipital nerves and migraine headache. Plast Reconstr Surg. 2005;115:1752–8.CrossRefGoogle Scholar
  10. 10.
    Ducic I, Hartmann EC, Larson EE. Indications and outcomes for surgical treatments of patients with chronic migraine headaches caused by occipital neuralgia. Plast Reconstr Surg. 2009;123:1453–61.CrossRefGoogle Scholar
  11. 11.
    Hunter CR, Mayfield FH. Role of the upper cervical roots in the production of pain in the head. Am J Surg. 1949;48:743–51.CrossRefGoogle Scholar
  12. 12.
    Klinger M, Villani F, Klinger F, Gaetani P, Rodriguez y Baena R, Levi D. Anatomical variations of the occipital nerves: implications for the treatment of chronic headaches. Plast Reconstr Surg. 2009;124:1727–8.CrossRefGoogle Scholar
  13. 13.
    Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006;118(Suppl 3):108S–20S.CrossRefGoogle Scholar
  14. 14.
    Klinger M, Lisa A, Klinger F, Giannasi S, Veronesi A, Banzatti B, Bandi V, Catania B, Forcellini D, Maione L, Vinci V, Caviggioli F. Regenerative approach to scars, ulcers and related problems with fat grafting. Clin Plast Surg. 2015;42(3):345–52.CrossRefGoogle Scholar
  15. 15.
    Maione L, Vinci V, Caviggioli F, Klinger F, Banzatti B, Catania B, Lisa A, Klinger M. Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy. Aesthet Plast Surg. 2014;38(3):528–32.  https://doi.org/10.1007/s00266-014-0311-9.CrossRefGoogle Scholar
  16. 16.
    Rigotti G, Marchi A, Galiè M, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adiposederived adult stem cells. Plast Reconstr Surg. 2007;119:1409–22.CrossRefGoogle Scholar
  17. 17.
    Zuk PA, Zhu M, Ashjian P, et al. Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell. 2002;13:4279–95.CrossRefGoogle Scholar
  18. 18.
    Mazo M, Planat-Bénard V, Abizanda G, et al. Transplantation of adipose derived stromal cells is associated with functional improvement in a rat model of chronic myocardial infarction. Eur J Heart Fail. 2008;10:454–62.CrossRefGoogle Scholar
  19. 19.
    Zhang DZ, Gai LY, Liu HW, Jin QH, Huang JH, Zhu XY. Transplantation of autologous adiposederived stem cells ameliorates cardiac function in rabbits with myocardial infarction. Chin Med J. 2007;120:300–7.CrossRefGoogle Scholar
  20. 20.
    Villani F, Caviggioli F, Klinger F, Klinger M. Rehabilitation of irradiated head and neck tissues by autologous fat transplantation. Plast Reconstr Surg. 2009;124:2190–1.CrossRefGoogle Scholar
  21. 21.
    Klinger M, Caviggioli F, Vinci V, Salval A, Villani F. Treatment of chronic posttraumatic ulcers using autologous fat graft. Plast Reconstr Surg. 2010;126:154e–5e.CrossRefGoogle Scholar
  22. 22.
    Villani F, Caviggioli F, Klinger F, Maione L, Klinger M. Fat graft before breast reconstruction by latissimus dorsi. Plast Reconstr Surg. 2010;126:190e–1e.CrossRefGoogle Scholar
  23. 23.
    Güvençer M, Akyer P, Sayhan S, Tetik S. The importance of the greater occipital nerve in the occipital and the suboccipital region for nerve blockade and surgical approaches—an anatomic study on cadavers. Clin Neurol Neurosurg. 2011;113:289–94.CrossRefGoogle Scholar
  24. 24.
    Bovim G, Fredriksen TA, Stolt-Nilsen A, Sjaastad O. Neurolysis of the greater occipital nerve in cervicogenic headache. A follow-up study. Headache. 1992;32:175–9.CrossRefGoogle Scholar
  25. 25.
    Gille O, Lavignolle B, Vital JM. Surgical treatment of greater occipital neuralgia by neurolysis of the great occipital nerve and sectioning of the inferior oblique muscle. Spine. 2004;29:828–32.CrossRefGoogle Scholar
  26. 26.
    Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005;115:1–9.PubMedGoogle Scholar
  27. 27.
    Pikus J, Philips JM. Characteristics of patients successfully treated for cervicogenic headache by surgical decompression of the second cervical root. Headache. 1995;35:921–9.CrossRefGoogle Scholar
  28. 28.
    Vanelderen P, Rouwette T, De Vooght P, et al. Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up. Reg Anesth Pain Med. 2010;35:148–51.CrossRefGoogle Scholar
  29. 29.
    Schwedt TJ. Occipital nerve stimulation for medically intractable headache. Cur Pain Headache Rep. 2008;12:62–6.CrossRefGoogle Scholar
  30. 30.
    Slavin KV, Nerseyan H, Wess C. Peripheral neurostimulationfor treatment of intractable occipital neuralgia. Neurosurgery. 2006;58:112–9.CrossRefGoogle Scholar
  31. 31.
    Taylor M, Silva S, Cottrell C. Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study. Headache. 2008;48:1476–81.CrossRefGoogle Scholar
  32. 32.
    Daar AS, Greenwood HL. A proposed definition of regenerative medicine. J Tissue Eng Regen Med. 2007;1:179–84.CrossRefGoogle Scholar
  33. 33.
    Gaetani P, Klinger M, Levi D, Bussone G, Giannasi S, Caviggioli F, Marazzi M, Broggi G. Treatment of chronic headache of cervical origin with lipostructure: an observational study. Headache. 2013;2013(53):507–13.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Marco Klinger
    • 1
    Email author
  • Luca Maione
    • 1
  • Francesco Klinger
    • 2
  • Silvia Giannasi
    • 1
  1. 1.Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research HospitalReconstructive and Aesthetic Plastic Surgery School, University of MilanRozzanoItaly
  2. 2.Plastic Surgery Unit, MultiMedica Holding S.p.AReconstructive and Aesthetic Plastic Surgery School, University of MilanMilanItaly

Personalised recommendations