Two patients with occipital neuralgia due to severe arthropathy of the C1–2 facet joint were treated using atlantoaxial fusion with transarticular screws without decompression of the C-2 nerve root. Both patients experienced immediate postoperative relief of occipital neuralgia. The resultant motion elimination at C1–2 eradicated not only the movement-evoked pain, but also the paroxysms of true occipital neuralgia occurring at rest. A possible pathophysiological explanation for this improvement is presented in the context of the ignition theory of neuralgic pain. This represents the first report of C1–2 transarticular screw fixation for the treatment of arthropathy-associated occipital neuralgia.
Abbreviation used in this paper: AAON = arthropathy-associated occipital neuralgia.