Occipital nerve stimulator systems: review of complications and surgical techniques.

Publication/Presentation Date

4-1-2010

Abstract

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.

Volume

13

Issue

2

First Page

121

Last Page

125

ISSN

1525-1403

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

21992786

Department(s)

Administration and Leadership

Document Type

Article

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