Advertisement

Occipital Nerve Stimulation for Refractory Pain after Occipitocervical Fusion

  • Giusy Guzzi
  • Attilio Della Torre
  • Donatella Gabriele
  • Giorgio Volpentesta
  • Domenico Chirchiglia
  • Carmelino Angelo Stroscio
  • Angelo Lavano
Chapter
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 125)

Abstract

Occipital nerve stimulation (ONS) is electric stimulation of the distal branches of the greater occipital nerve by cylindrical or paddle leads implanted in subcutaneous occipital tissue. This surgical option has emerged as a promising treatment for different types of disabling medical refractory headache and recently also for residual occipital and nuchal pain after previous occipitocervical fusion. The mechanisms of action have not yet been clearly explained: electrical stimulation of the occipital nerve has both peripheral and central effects on the nervous system, which may modulate nociception. ONS is a well-tolerated and safe procedure in comparison with other invasive modalities of treatment. Lead migration/dislodgement is a common complication, but use of new surgical techniques and leads may reduce the rate of this complication.

Notes

Competing Interests

The authors declare that they have no competing interests.

Compliance with Ethical Standards

No financial support was received for this work.

References

  1. 1.
    Vallejo R, Benyamin R, Kramer J. Neuromodulation of the occipital nerve in pain management. Tech Reg Anesth Pain Manag. 2006;10:12–5.CrossRefGoogle Scholar
  2. 2.
    Schwedt T. Occipital nerve stimulation for medically intractable headache. Curr Pain Headache Rep. 2008;12:62–6.CrossRefGoogle Scholar
  3. 3.
    Paemeleire K, Bartsch T. Occipital nerve stimulation for headache disorders. Neurotherapeutics. 2010;7(2):213–9.CrossRefGoogle Scholar
  4. 4.
    Goasby PJ. Neuromodulatory approaches to the treatment of trigeminal autonomic cephalalgias. Acta Neurochir Suppl. 2007;97(2):99–110.CrossRefGoogle Scholar
  5. 5.
    Weiner RL. Occipital neurostimulation for treatment of intractable headache syndromes. Acta Neurochir Suppl. 2007;97(1):129–33.PubMedGoogle Scholar
  6. 6.
    Ghaemi K, Capelle HH, Kinfe TM, Krauss JK. Occipital nerve stimulation for refractory occipital pain after occipitocervical fusion: expanding indications. Stereotact Funct Neurosurg. 2008;86(6):391–3.CrossRefGoogle Scholar
  7. 7.
    Slavin KV, Nersesyan H, Wess C. Peripheral neurostimulation for treatment of occipital neuralgia. Neurosurgery. 2006;58:112–9.CrossRefGoogle Scholar
  8. 8.
    Franzini A, Messina G, Leone M, Broggi G. Occipital nerve stimulation (ONS): surgical technique and prevention of late electrode migration. Acta Neurochir (Wien). 2009;151:861–5.CrossRefGoogle Scholar
  9. 9.
    Abhinav K, Park ND, Prakash SK, Love-Jones S, Patel NK. Novel use of narrow paddle electrodes for occipital nerve stimulation: technical note. Neuromodulation. 2013;16(6):607–9.CrossRefGoogle Scholar
  10. 10.
    Lee P, Billy K. Peripheral nerve stimulation for the treatment of primary headache. Curr Pain Headache Rep. 2013;17:319.CrossRefGoogle Scholar
  11. 11.
    Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999;2:217–21.CrossRefGoogle Scholar
  12. 12.
    Lavano A, De Rose M, Guzzi G, Romano M, Della Torre A, et al. Neurostimulation for the treatment of cluster headache. Austin J Anesth Analg. 2015;3(1):1041.Google Scholar
  13. 13.
    Schwedt TJ, Dodick DW, Hentz J, Trentman T, Zimmerman R. Occipital nerve stimulation for chronic headache, long-term safety and efficacy. Cephalalgia. 2007;27:153–7.CrossRefGoogle Scholar
  14. 14.
    Matharu MS, Bartsch T, Ward N. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004;127:220–30.CrossRefGoogle Scholar
  15. 15.
    Chen YF, Bramley G, Unwin G, Hanu-Cernat D, Dretzke J, Moore D, Bayliss S, Cummins C, Lilford R. Occipital nerve stimulation for chronic migraine—a systematic review and meta-analysis. PLoS One. 2015;10(3):e0116786.CrossRefGoogle Scholar
  16. 16.
    Silberstein SD, Dodick DW, Sape J, Huch B, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: results from a randomized, multicenter, double-blinded, controlled study. Cephalalgia. 2012;32(16):1165–79.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Giusy Guzzi
    • 1
  • Attilio Della Torre
    • 1
  • Donatella Gabriele
    • 1
  • Giorgio Volpentesta
    • 1
  • Domenico Chirchiglia
    • 1
  • Carmelino Angelo Stroscio
    • 1
  • Angelo Lavano
    • 1
  1. 1.Department of NeurosurgeryMagna Graecia University of CatanzaroCatanzaroItaly

Personalised recommendations