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High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review

BACKGROUND: Occipital neuralgia (ON) is defined as paroxysmal pain in the distribution of the greater, lesser, and/or third occipital nerves. ON can be refractory to conservative management and minimally invasive interventions. Neuromodulatory procedures can potentially treat refractory ON and inclu...

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Autores principales: Texakalidis, Pavlos, Tora, Muhibullah S, Nagarajan, Purva, Keifer, Orion P, Boulis, Nicholas M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708893/
https://www.ncbi.nlm.nih.gov/pubmed/31686897
http://dx.doi.org/10.2147/JPR.S214314
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author Texakalidis, Pavlos
Tora, Muhibullah S
Nagarajan, Purva
Keifer, Orion P
Boulis, Nicholas M
author_facet Texakalidis, Pavlos
Tora, Muhibullah S
Nagarajan, Purva
Keifer, Orion P
Boulis, Nicholas M
author_sort Texakalidis, Pavlos
collection PubMed
description BACKGROUND: Occipital neuralgia (ON) is defined as paroxysmal pain in the distribution of the greater, lesser, and/or third occipital nerves. ON can be refractory to conservative management and minimally invasive interventions. Neuromodulatory procedures can potentially treat refractory ON and include occipital nerve stimulation and the sparsely reported high cervical spinal cord stimulation (SCS). OBJECTIVE: To report our experience and conduct a systematic literature review of studies evaluating the effect of high cervical SCS as a treatment modality for refractory ON. METHODS: A retrospective review of patients with refractory ON who underwent high cervical SCS was conducted. In addition, a systematic literature review was performed according to the PRISMA guidelines. RESULTS: Five patients with refractory ON were treated with high cervical (C1–C3) SCS in our institution. Two out of five (40%) patients reported a successful trial stimulation (>50% pain reduction) and received permanent implantation. During the follow-up, the visual analog scale score decreased from 7.5 to 4 and from 6.5 to 5 in these patients. No complications were reported for any of the patients. The systematic literature review, identified two eligible studies, comprising 18 patients overall who underwent cervicomedullary junction SCS. Nine out of 18 patients (50%) had a successful trial and received permanent implantation. CONCLUSION: High cervical or cervicomedullary junction SCS is associated with a 40–50% successful trial rate in refractory ON. No major complications were noted during the follow-up. Future studies are needed to compare the different neurosurgical options, in order to identify the optimal treatment strategy for refractory ON.
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spelling pubmed-67088932019-11-04 High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review Texakalidis, Pavlos Tora, Muhibullah S Nagarajan, Purva Keifer, Orion P Boulis, Nicholas M J Pain Res Case Series BACKGROUND: Occipital neuralgia (ON) is defined as paroxysmal pain in the distribution of the greater, lesser, and/or third occipital nerves. ON can be refractory to conservative management and minimally invasive interventions. Neuromodulatory procedures can potentially treat refractory ON and include occipital nerve stimulation and the sparsely reported high cervical spinal cord stimulation (SCS). OBJECTIVE: To report our experience and conduct a systematic literature review of studies evaluating the effect of high cervical SCS as a treatment modality for refractory ON. METHODS: A retrospective review of patients with refractory ON who underwent high cervical SCS was conducted. In addition, a systematic literature review was performed according to the PRISMA guidelines. RESULTS: Five patients with refractory ON were treated with high cervical (C1–C3) SCS in our institution. Two out of five (40%) patients reported a successful trial stimulation (>50% pain reduction) and received permanent implantation. During the follow-up, the visual analog scale score decreased from 7.5 to 4 and from 6.5 to 5 in these patients. No complications were reported for any of the patients. The systematic literature review, identified two eligible studies, comprising 18 patients overall who underwent cervicomedullary junction SCS. Nine out of 18 patients (50%) had a successful trial and received permanent implantation. CONCLUSION: High cervical or cervicomedullary junction SCS is associated with a 40–50% successful trial rate in refractory ON. No major complications were noted during the follow-up. Future studies are needed to compare the different neurosurgical options, in order to identify the optimal treatment strategy for refractory ON. Dove 2019-08-21 /pmc/articles/PMC6708893/ /pubmed/31686897 http://dx.doi.org/10.2147/JPR.S214314 Text en © 2019 Texakalidis et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Series
Texakalidis, Pavlos
Tora, Muhibullah S
Nagarajan, Purva
Keifer, Orion P
Boulis, Nicholas M
High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title_full High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title_fullStr High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title_full_unstemmed High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title_short High cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
title_sort high cervical spinal cord stimulation for occipital neuralgia: a case series and literature review
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708893/
https://www.ncbi.nlm.nih.gov/pubmed/31686897
http://dx.doi.org/10.2147/JPR.S214314
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