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The surgical technique of occipital nerve stimulation

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Abstract

Background

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.

Method

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.

Conclusions

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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References

  1. Bartsch T, Goadsby PJ (2002) Stimulation of the greater occipital nerve induces increased central excitability of dural afferent input. Brain 125:1496–1509

    Article  PubMed  Google Scholar 

  2. Becser N, Bovim G, Sjaastad O (1998) Extracranial nerves in the posterior part of the head. Anatomic variations and their possible clinical significance. Spine (Phila Pa 1976) 23:1435–1441

    Article  CAS  Google Scholar 

  3. Brewer AC, Trentman TL, Ivancic MG, Vargas BB, Rebecca AM, Zimmerman RS, Rosenfeld DM, Dodick DW (2013) Long-term outcome in occipital nerve stimulation patients with medically intractable primary headache disorders. Neuromodulation 16:557–562, discussion 563–554

    Article  PubMed  Google Scholar 

  4. Le Doare K, Akerman S, Holland PR, Lasalandra MP, Bergerot A, Classey JD, Knight YE, Goadsby PJ (2006) Occipital afferent activation of second order neurons in the trigeminocervical complex in rat. Neurosci Lett 403:73–77

    Article  PubMed  Google Scholar 

  5. Skaribas I, Alo K (2010) Ultrasound imaging and occipital nerve stimulation. Neuromodulation 13:126–130

    Article  PubMed  Google Scholar 

  6. Trentman TL, Dodick DW, Zimmerman RS, Birch BD (2008) Percutaneous occipital stimulator lead tip erosion: report of 2 cases. Pain Physician 11:253–256

    PubMed  Google Scholar 

  7. Weiner RL, Reed KL (1999) Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation 2:217–221

    Article  CAS  PubMed  Google Scholar 

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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). https://doi.org/10.1007/s00701-014-2281-8

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  • DOI: https://doi.org/10.1007/s00701-014-2281-8

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