Reoperation following Primary Greater Occipital Nerve Decompression Surgery: Incidence, Risk Factors, and Outcomes
Bibliographic record
Abstract
BACKGROUND: Although nerve decompression surgery is an effective treatment for refractory occipital neuralgia, a proportion of patients experience recurrence of pain and undergo reoperation. This study analyzes the incidence, risk factors, and outcomes of reoperation following primary greater occipital nerve (GON) decompression. METHODS: A total of 215 patients who underwent 399 primary GON decompressions were prospectively enrolled. Data included patient demographics, medical and surgical history, reoperation rates, intraoperative findings, surgical technique, and postoperative outcomes in terms of pain frequency (days per month), duration (hours per day), intensity (scale, 0 to 10), and migraine headache index. Bivariate analyses, univariable logistic regression analysis, and multivariable logistic regression analysis, were performed. RESULTS: Twenty-seven GON decompressions (6.8%) required reoperation with neurectomy at a median follow-up time of 15.5 months (range, 9.8 to 40.5 months). Cervical spine disorders on imaging that did not warrant surgical intervention (OR, 4.88; 95% CI, 1.61 to 14.79; P < 0.01) and radiofrequency ablation (OR, 4.20; 95% CI, 1.45 to 15.2; P < 0.05) were significantly associated with higher rates of reoperation. At 12 months postoperatively, patients who underwent reoperation achieved similar mean reductions in pain frequency, duration, intensity, and migraine headache index, as compared with patients who underwent only primary decompression ( P > 0.05). CONCLUSION: Patients with occipital neuralgia who have a history of cervical spine disorders or radiofrequency ablation should be counseled that primary decompression has a higher risk of reoperation, but outcomes are ultimately comparable. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".