Cervical Spinal Cord Stimulation for the Treatment of Headache Disorders: A Systematic Review

Finnern, Michael T.; D’Souza, Ryan S; Jin, Max Y.; Abd‐Elsayed, Alaa

doi:10.1016/j.neurom.2022.10.060

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…This neuromodulation technique has broad applications and has been shown to be an effective analgesic for patients who suffer from chronic pain when targeting the thoracic and cervical spine [45]. One review article assessed SCS use across four studies on patients with migraine and found that all four studies reported a decrease in migraine intensity and pain [38]. However, given small sample sizes, the studies were limited and did not offer statistical significance for their findings, prompting the authors to conclude that there is low-quality evidence to support the use of SCS for headache [38].…”

Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 99%

Neuromodulation Techniques for Headache Management

Reffat,

Pusec,

Price

et al. 2024

Life

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This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. A search was conducted in PubMed in August of 2023 to survey the current literature on neuromodulation for the treatment of headache. In total, the search yielded 1989 results, which were further filtered to include only systematic reviews published between 2022 to 2023 to capture the most up-to-date and comprehensive research on this topic. The citation lists of these articles were reviewed to find additional research on neuromodulation and supplement the results presented in this paper with primary literature. Research on the use of neuromodulation for the treatment of headache has predominantly focused on four neuromodulation techniques: peripheral nerve stimulation (PNS), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and spinal cord stimulation (SCS). Outcome measures reported in this article include impact on migraine and headache frequency and/or pain intensity, adverse effects of the neuromodulation technique, and associated costs, when available. We found that neuromodulation has developed utility as an alternative treatment for both chronic cluster headaches and migraines, with a reduction in frequency and intensity of headache most elucidated from the articles mentioned in this review.

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Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 99%

Neuromodulation Techniques for Headache Management

Reffat,

Pusec,

Price

et al. 2024

Life

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show abstract

“…53 One review article assessed SCS use across four studies on patients with migraine, and found that all four studies described a decrease in migraine intensity and pain. 54 However, given small sample sizes, the studies were limited and did not offer statistical significance for their findings, prompting the authors to conclude that there is low quality evidence to support the use of SCS for headache. 54 The most commonly cited adverse event associated with this therapy included pain at the site of implantation of the pulse generator.…”

Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 99%

“…54 However, given small sample sizes, the studies were limited and did not offer statistical significance for their findings, prompting the authors to conclude that there is low quality evidence to support the use of SCS for headache. 54 The most commonly cited adverse event associated with this therapy included pain at the site of implantation of the pulse generator. 53 Other events included displacement of leads following placement, and defective devices.…”

Section: Spinal Cord Stimulation (Scs)mentioning

confidence: 99%

Neuromodulation Techniques for Headache Management

Reffat,

Pusec,

Price

et al. 2023

Preprint

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This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. We performed a narrative review of the literature to identify studies that detail the effectiveness of neuromodulation therapies in the treatment of headache syndromes. The literature was refined to predominantly focus on systematic reviews published in the last year that have the most robust reporting of research done on this topic. Patients with headache face several challenges, including medication overuse, cost burden, non-compliance to medications due to inability to tolerate side effects, or treatments that are ineffective. Neuromodulation is an emerging field that encompasses implantable and non-implantable technologies that intervene on the signaling and perception of pain. In recent years, this technology has been used as an analgesic, and has been shown to be effective for treatment-resistant headache, particularly when used in patients with migraine and chronic cluster headache.

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“…Specific pain conditions that can be managed by SCS include painful diabetic neuropathy, complex regional pain syndrome, and failed back surgery syndrome [2,3]. The indications for SCS are progressively broadening with recent evidence supporting its use in the treatment of several headache conditions and chemotherapy-induced neuropathy [4,5].…”

Section: Introductionmentioning

confidence: 99%

Animal Feasibility Study of a Novel Spinal Cord Stimulation Multicolumn Lead (Heron Lead)

Mertens¹,

Cantone²,

Antonini³

et al. 2023

Discovery Medicine

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Background: Currently available spinal cord stimulation paddle leads require a laminectomy, limiting the types of clinicians who can implant and increasing the risk of complications. Recently, WISE S.r.l. designed a prototype multicolumn lead named the Heron® lead that can be implanted percutaneously. The purpose of the study was to examine the efficiency of placing a paddle lead percutaneously. Methods: Ten sheep were assigned to either the Heron lead group (n = 7) or the control group (n = 3). The sheep were observed for 13 weeks after implantation. Neurological and clinical examinations were conducted prior to surgery and then during the follow-up period. The implantation sites were evaluated through macroscopic observations during the article explantation and the lead migration was evaluated by comparing the article positioning at the surgery, four weeks after the surgery and at the explantation day through fluoroscope images. A qualitative comparison was made between the results collected with the test article and the control article. Results: Observations at the surgical sites indicate that test animals appeared to have less swelling around the surgical wound than control ones in the first 14 days, but no impact on wound healing was noticed. Additionally, no clear difference was observed in pain scores between the two groups, with observations tending to show that the maximum pain was occurring later in the test group with respect to the control group. General clinical observations showed no major difference between the two groups, and determined clinical abnormalities were not directly related to the procedure. Lastly, neurological deficits frequency decreased from the first to last animal operated, regardless of their test or control status. Conclusions: Our study concluded that the Heron lead is safe to implant, with a safety profile similar to the control article. Additionally, we conclude that the Heron lead is effective in reducing lead migration events.

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Cervical Spinal Cord Stimulation for the Treatment of Headache Disorders: A Systematic Review

Cited by 6 publications

References 40 publications

Neuromodulation Techniques for Headache Management

Neuromodulation Techniques for Headache Management

Neuromodulation Techniques for Headache Management

Animal Feasibility Study of a Novel Spinal Cord Stimulation Multicolumn Lead (Heron Lead)

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