Cervicomedullary Junction Spinal Cord Stimulation for Head and Facial Pain

Tomycz, Nestor D.; Deibert, Christopher P.; Moossy, John

doi:10.1111/j.1526-4610.2010.01829.x

Cited by 49 publications

(34 citation statements)

References 47 publications

(90 reference statements)

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“…have implanted paddle leads in the cervicomedullary junction in patients with intractable head or facial pain, and they conclude that patients suffering from trigeminal deafferentation pain, trigeminal neuropathic pain, and post-herpetic neuralgia may respond favorably to SCS, whereas, patients with occipital neuralgia are rarely relieved by this technique. [154] The results of SCS for post-herpetic neuralgia are controversial. [415098] Herke et al .…”

Section: Indications and Resultsmentioning

confidence: 99%

Dorsal column stimulator applications

Yampolsky¹,

Hem²,

Bendersky³

2012

Surg Neurol Int

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Background:Spinal cord stimulation (SCS) has been used to treat neuropathic pain since 1967. Following that, technological progress, among other advances, helped SCS become an effective tool to reduce pain.Methods:This article is a non-systematic review of the mechanism of action, indications, results, programming parameters, complications, and cost-effectiveness of SCS.Results:In spite of the existence of several studies that try to prove the mechanism of action of SCS, it still remains unknown. The mechanism of action of SCS would be based on the antidromic activation of the dorsal column fibers, which activate the inhibitory interneurons within the dorsal horn. At present, the indications of SCS are being revised constantly, while new applications are being proposed and researched worldwide. Failed back surgery syndrome (FBSS) is the most common indication for SCS, whereas, the complex regional pain syndrome (CRPS) is the second one. Also, this technique is useful in patients with refractory angina and critical limb ischemia, in whom surgical or endovascular treatment cannot be performed. Further indications may be phantom limb pain, chronic intractable pain located in the head, face, neck, or upper extremities, spinal lumbar stenosis in patients who are not surgical candidates, and others.Conclusion:Spinal cord stimulation is a useful tool for neuromodulation, if an accurate patient selection is carried out prior, which should include a trial period. Undoubtedly, this proper selection and a better knowledge of its underlying mechanisms of action, will allow this cutting edge technique to be more acceptable among pain physicians.

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Section: Indications and Resultsmentioning

confidence: 99%

Dorsal column stimulator applications

Yampolsky¹,

Hem²,

Bendersky³

2012

Surg Neurol Int

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“…Almost all modes of neuromodulation has been tried to alleviate pain in this condition [Table 10], however, only PNS[2460148] and DBS[4647119] modality showed some efficacy in single case reports. TGSs,[153] cervical SCS,[155] and MCS[1226162] have been used for this condition. MCS failed to relieve painful condition in one report[26] but achieved pain control in all three patients from two other centers.…”

Section: Methodsmentioning

confidence: 99%

Neuromodulation for cephalgias

Rasskazoff

Slavin²

2013

Surg Neurol Int

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Headaches (cephalgias) are a common reason for patients to seek medical care. There are groups of patients with recurrent headache and craniofacial pain presenting with malignant course of their disease that becomes refractory to pharmacotherapy and other medical management options. Neuromodulation can be a viable treatment modality for at least some of these patients. We review the available evidence related to the use of neuromodulation modalities for the treatment of medically refractory craniofacial pain of different nosology based on the International Classification of Headache Disorders, 2nd edition (ICHD-II) classification. This article also reviews the scientific rationale of neuromodulation application in management of cephalgias.

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“…4,40,41 The procedure is usually performed in a similar manner to a standard thoracic spinal cord stimulator with somatosensory evoked potential monitoring. The quadripolar paddle leads are implanted in a retrograde manner following a C1 hemilaminotomy with the proximal contacts directed at the cervicomedullary junction.…”

Section: Cervical Spinal Cord Stimulation For Craniofacial Painmentioning

confidence: 99%

“…A study evaluating the efficacy of cervical SCS in 41 patients with intractable upper limb and facial pain concluded that the patients with face pain did not respond to this therapy. 4 A recent retrospective study 41 showed that this therapy is a good option for trigeminal deafferentation pain with greater than 70% of patients in this group having a positive result, while not a good option for occipital neuralgic pain (only 28% response). However, this study is limited by its small sample size and thus large scale clinical trials are warranted.…”

Section: Cervical Spinal Cord Stimulation For Craniofacial Painmentioning

confidence: 99%