Background The aim of this study was to a) evaluate the time between onset of occipital neuralgia symptoms and nerve decompression surgery, b) perform a cost comparison analysis between surgical and non-surgical treatment of occipital neuralgia and c) report postoperative results of nerve decompression for occipital neuralgia. Methods 1,112 subjects who underwent screening for nerve decompression surgery were evaluated for occipital neuralgia. 367 (33%) patients met the inclusion criteria. Timing of occipital neuralgia symptom onset and pain characteristics were prospectively collected. Cost associated with the non-surgical treatment of occipital neuralgia was calculated for the period between onset of symptoms and surgery. Results 226 (73%) patients underwent occipital nerve decompression. The average time between onset of occipital neuralgia and surgery was 19 years (7.1–32). Postoperatively, the median number of pain days per month decreased by 17 (0–26, 57%) (p < 0.001), the median pain intensity decreased by 4 (2–8, 44%) (p < 0.001), and median pain duration in hours was reduced by 12 (2–23, 50%) (p < 0.001). The annual mean cost of non-surgical occipital neuralgia treatment was $28,728.82 ($16,419.42-$41,198.41) per patient. The mean cost during the 19-year timeframe prior to surgery was $545,847.75($311,968.90-$782,769.82). Conclusion This study demonstrates that patients suffer from occipital neuralgia for an average of 19 years prior to undergoing surgery. Nerve decompression reduces symptom severity significantly and should be considered earlier in the treatment course of occipital neuralgia that is refractory to conservative treatment to prevent patient morbidity and decrease direct and indirect healthcare costs. IRB registration number & name Weill Cornell Medicine: 23-04025985, Prospective Cohort Study Investigating Long- Term Outcomes After Headache Surgery. The Massachusetts General Hospital: 2012P001527, Correlation of pre-operative pain self-efficacy and post-operative migraine-specific symptoms and disability.

中文翻译：

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从枕部神经痛症状出现到神经减压手术治疗的治疗延迟：一项前瞻性队列研究

背景 本研究的目的是 a) 评估枕神经痛症状发作与神经减压手术之间的时间，b) 对枕神经痛的手术和非手术治疗进行成本比较分析，c) 报告神经减压术后结果用于枕部神经痛。方法 对 1,112 名接受神经减压手术筛查的受试者进行枕神经痛评估。367 名 (33%) 患者符合纳入标准。前瞻性收集枕神经痛症状出现的时间和疼痛特征。计算症状出现和手术之间的时间段与枕神经痛非手术治疗相关的费用。结果 226 名（73%）患者接受了枕神经减压术。枕神经痛发作与手术之间的平均时间为 19 年 (7.1-32)。术后，每月疼痛天数中位数减少 17 天 (0–26, 57%) (p < 0.001)，疼痛强度中位数减少 4 (2–8, 44%) (p < 0.001)，中位疼痛持续时间（以小时为单位）减少了 12 小时（2-23，50%）（p < 0.001）。每位患者非手术枕神经痛治疗的年平均费用为 28,728.82 美元（16,419.42 美元-41,198.41 美元）。手术前 19 年期间的平均费用为 545,847.75 美元（311,968.90 美元-782,769.82 美元）。结论 这项研究表明，患者在接受手术前平均患有枕神经痛 19 年。神经减压可显着减轻症状严重程度，应在保守治疗无效的枕神经痛治疗过程中尽早考虑，以防止患者发病并降低直接和间接医疗费用。IRB 注册号和名称 Weill Cornell Medicine：23-04025985，调查头痛手术后长期结果的前瞻性队列研究。马萨诸塞州总医院：2012P001527，术前疼痛自我效能与术后偏头痛特异性症状和残疾的相关性。