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

2019 ◽  
Vol Volume 12 ◽  
pp. 2547-2553
Author(s):  
Pavlos Texakalidis ◽  
Muhibullah S Tora ◽  
Purva Nagarajan ◽  
Orion P Keifer Jr ◽  
Nicholas Boulis
Keyword(s):  
Spinal Cord ◽  
Literature Review ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Case Series ◽  
Occipital Neuralgia ◽  
High Cervical

High-Cervical Spinal Cord Stimulation for Medically Intractable Chronic Migraine

2014 ◽  
Vol 18 (4) ◽  
pp. 289-296 ◽  
Author(s):  
Rinaldo De Agostino ◽  
Barbara Federspiel ◽  
Evaldas Cesnulis ◽  
Peter S. Sandor
Keyword(s):  
Spinal Cord ◽  
Chronic Migraine ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
High Cervical

scholarly journals Neuromodulation of the Cervical Spinal Cord in the Treatment of Chronic Intractable Neck and Upper Extremity Pain: A Case Series and Review of the Literature

2007 ◽  
Vol 2;10 (3;2) ◽  
pp. 305-311
Author(s):  
Ricardo Vallejo
Keyword(s):  
Spinal Cord ◽  
Upper Extremity ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Case Series ◽  
Low Back ◽  
Limb Pain ◽  
Fusion Surgery ◽  
Upper Limb Pain ◽  
Pain Patients

Electrical spinal neuromodulation in the form of spinal cord stimulation is currently used for treating chronic painful conditions such as complex regional pain syndrome, diabetic neuropathy, postherpetic neuralgia, peripheral ischemia, low back pain, and other conditions refractory to more conservative treatments. To date, there are very few published reports documenting the use of spinal cord stimulation in the treatment of head/neck and upper limb pain. This paper reports a case series of 5 consecutive patients outlining the use of spinal cord stimulation to treat upper extremity pain. All subjects had previously undergone cervical fusion surgery to treat chronic neck and upper limb pain. Patients were referred following failure of the surgery to manage their painful conditions. Spinal cord stimulators were placed in the cervical epidural space through a thoracic needle placement. Stimulation parameters were adjusted to capture as much of the painful area(s) as possible. In total, 4 out of 5 patients moved to implantation. In all cases, patients reported significant (70–90%) reductions in pain, including axial neck pain and upper extremity pain. Interestingly, 2 patients with associated headache and lower extremity pain obtained relief after paresthesia-steering reportedly covered those areas. Moreover, 2 patients reported that cervical spinal cord stimulation significantly improved axial low back pain. Patients continue to report excellent pain relief up to 9 months following implantation. This case series documents the successful treatment of neck and upper extremity pain following unsuccessful cervical spine fusion surgery. Given this initial success, prospective, controlled studies are warranted to more adequately assess the long term utility and cost effectiveness of electrical neuromodulation treatment of chronic neck and upper extremity pain. Key words: spinal cord stimulator, cervical, neck pain, radicular pain, axial pain, headache, leg pain

Cervical Spinal Cord Stimulation for Spasticity in Cerebral Palsy

Neurosurgery ◽  
1988 ◽  
Vol 22 (4) ◽  
pp. 707-714 ◽  
Author(s):  
Herman Hugenholtz ◽  
Peter Humphreys ◽  
William M. J. McIntyre ◽  
Robert A. Spasoff ◽  
Kate Steel
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Fine Motor ◽  
Base Line ◽  
Double Blind Study ◽  
Self Assessment ◽  
Double Blind ◽  
Chronic Stimulation ◽  
High Cervical

Abstract A prospective double-blind study of high cervical spinal cord stimulation conducted in eight moderately disabled, spastic, cerebral palsied children failed to demonstrate any significant improvement over base line function during chronic spinal cord stimulation at either optimal stimulation parameters or random placebo parameters. Chronic stimulation included 4 consecutive months of stimulation for 24 hours each day. Stimulators were randomly programmed at optimal parameters for 2 of the 4 months and at placebo parameters for the remaining 2 months. At the end of each month of chronic stimulation, subjects were assessed with a multidisciplinary test battery that included a self-assessment, specific clinical examinations, tests of gross and fine motor control, neuropsychological and neurophysiological tests, a detailed gait analysis, and video recordings. By 6 months after the completion of the study, only 1 of the 8 subjects continued to use his stimulator on a regular basis, with minimal benefit.

High cervical spinal cord stimulation for chronic cluster headache

Cephalalgia ◽  
2011 ◽  
Vol 31 (11) ◽  
pp. 1170-1180 ◽  
Author(s):  
Tilman Wolter ◽  
Andrea Kiemen ◽  
Holger Kaube
Keyword(s):  
Spinal Cord ◽  
Cluster Headache ◽  
Nerve Stimulation ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Chronic Cluster Headache ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
The Mean ◽  
High Cervical

Background: Cluster headache (CH) is the most painful and debilitating primary headache syndrome. Conventional treatment combines acute and prophylactic drugs. Also with maximal therapy a substantial proportion of patients do not experience a meaningful prevention or pain relief. Recent case series and early trials have suggested that occipital nerve stimulation can be very effective in the management of intractable CH. Methods: Seven patients with medically intractable chronic cluster headache were implanted with high cervical epidural electrodes. After a median test phase of 10 days (range 4–19 days) an impulse generator was implanted subcutaneously. Mean follow up was 23 months (median 12 months, range 3–78 months). Results: All patients showed significant treatment effects. In all patients, improvement occurred immediately after electrode implantation. The mean attack frequency decreased, as well as the mean duration and intensity of attacks. Also, depression, anxiety, and pain-related impairment scores decreased and medication intake was markedly reduced. Conclusions: In this prospective series, high cervical spinal cord stimulation shows an effect size equal or larger than occipital nerve stimulation with immediate onset after surgery and may serve as a valuable additional treatment option of intractable cluster headache in the future.

scholarly journals High Cervical Spinal Cord Stimulation: A One Year Follow-Up Study on Motor and Non-Motor Functions in Parkinson’s Disease

2019 ◽  
Vol 9 (4) ◽  
pp. 78 ◽  
Author(s):  
Paolo Mazzone ◽  
Fabio Viselli ◽  
Stefano Ferraina ◽  
Margherita Giamundo ◽  
Massimo Marano ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Spinal Cord ◽  
Parkinson's Disease ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Motor Task ◽  
Motor Deficits ◽  
Failed Back Surgery ◽  
One Year ◽  
High Cervical

Background: The present study investigated the effectiveness of stimulation applied at cervical levels on pain and Parkinson’s disease (PD) symptoms using either tonic or burst stimulation mode. Methods: Tonic high cervical spinal cord stimulation (T-HCSCS) was applied on six PD patients suffering from low back pain and failed back surgery syndrome, while burst HCSCS (B-HCSCS) was applied in twelve PD patients to treat primarily motor deficits. Stimulation was applied percutaneously with quadripolar or octapolar electrodes. Clinical evaluation was assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn and Yahr (H&Y) scale. Pain was evaluated by a visual analog scale. Evaluations of gait and of performance in a cognitive motor task were performed in some patients subjected to B-HCSCS. One patient who also suffered from severe autonomic cardiovascular dysfunction was investigated to evaluate the effectiveness of B-HCSCS on autonomic functions. Results: B-HCSCS was more effective and had more consistent effects than T-HCSCS in reducing pain. In addition, B-HCSCS improved UPDRS scores, including motor sub-items and tremor and H&Y score. Motor benefits appeared quickly after the beginning of B-HCSCS, in contrast to long latency improvements induced by T-HCSCS. A slight decrease of effectiveness was observed 12 months after implantation. B-HCSCS also improved gait and ability of patients to correctly perform a cognitive–motor task requiring inhibition of a prepared movement. Finally, B-HCSCS ameliorated autonomic control in the investigated patient. Conclusions: The results support a better usefulness of B-HCSCS compared to T-HCSCS in controlling pain and specific aspects of PD motor and non-motor deficits for at least one year.

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