INTRODUCTION: Stimulation of the occipital nerves is becoming more widely accepted in the treatment of occipital neuritis and migraine disorders. OBJECTIVE: Presently, equipment available for spinal cord stimulation is adapted for insertion into the subcutaneous space over the occipital nerves. Many technical factors need to be reassessed to optimize the therapy. METHODS: We performed a retrospective review of patients implanted from 2003 to 2007 at a single center. We aimed to analyze the rate of surgical complications related to implantation technique. A total of 28 patients were present for analysis. Patients were followed up to 60 months with a mean follow-up of 21 months. RESULTS: There is a 32% revision rate for electrode migration or displacement, 3.6% removal rate for infection, and a 21% removal rate for lack of efficacy. Although not well studied secondary to small patient populations, this was consistent with a review of the literature which demonstrated a 10-60% revision rate. Other factors such as anchoring strategy, strain relief, and battery location were all considered in the analysis and will be presented. A major determination was that use of a second incision with an additional strain relief loop had only a 10% revision rate of the lead while those without this additional strain relief loop had a 62.5% revision rate. CONCLUSION: Many technical factors need to be addressed for optimization of occipital nerve stimulation.
INTRODUCTION: Stimulation of the occipital nerves is becoming more widely accepted in the treatment of occipital neuritis and migraine disorders. OBJECTIVE: Presently, equipment available for spinal cord stimulation is adapted for insertion into the subcutaneous space over the occipital nerves. Many technical factors need to be reassessed to optimize the therapy. METHODS: We performed a retrospective review of patients implanted from 2003 to 2007 at a single center. We aimed to analyze the rate of surgical complications related to implantation technique. A total of 28 patients were present for analysis. Patients were followed up to 60 months with a mean follow-up of 21 months. RESULTS: There is a 32% revision rate for electrode migration or displacement, 3.6% removal rate for infection, and a 21% removal rate for lack of efficacy. Although not well studied secondary to small patient populations, this was consistent with a review of the literature which demonstrated a 10-60% revision rate. Other factors such as anchoring strategy, strain relief, and battery location were all considered in the analysis and will be presented. A major determination was that use of a second incision with an additional strain relief loop had only a 10% revision rate of the lead while those without this additional strain relief loop had a 62.5% revision rate. CONCLUSION: Many technical factors need to be addressed for optimization of occipital nerve stimulation.
Authors: Steven M Wellman; James R Eles; Kip A Ludwig; John P Seymour; Nicholas J Michelson; William E McFadden; Alberto L Vazquez; Takashi D Y Kozai Journal: Adv Funct Mater Date: 2017-07-19 Impact factor: 18.808
Authors: Rafael Caiado Vencio; Paulo Eduardo Albuquerque Zito Raffa; André Costa Corral Ponce; Bruno Pricoli Malamud; César Cozar Pacheco; Paulo Roberto Franceschini; Roger Thomaz Rotta Medeiros; Paulo Henrique Pires de Aguiar Journal: Surg Neurol Int Date: 2021-04-26