The surgical technique of occipital nerve stimulation



Occipital nerve stimulation is increasingly used in the treatment of primary headache disorders. We describe a surgical technique applying preoperative fluoroscopy and intraoperative tactile orientation designed to reduce radiation exposure and provide reproducible results.


Under general anesthesia and in the supine position, the C1-C2 transition is identified fluoroscopically and marked with an electrocardiogram (ECG) electrode prior to surgery. During electrode placement, the ECG electrodes are used for tactile orientation of electrode direction and depth.


The use of tactile orientation solely during surgery reduces radiation exposure and decreases the duration of surgery. This technique allows reproducible results of final electrode position.

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Conflicts of interest

JV is a consultant for St Jude Medical (SJM), receiving payment for preparing and giving educational presentations as well as reimbursement for travel expenses. PJS received payments for preparing and giving educational presentations as well as reimbursement for travel expenses from SJM. GB received reimbursement for travel expenses from SJM.

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Correspondence to P. J. Slotty.

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Slotty, P.J., Bara, G. & Vesper, J. The surgical technique of occipital nerve stimulation. Acta Neurochir 157, 105–108 (2015).

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  • Occipital nerve stimulation
  • Surgical technique