Electrode migration is a challenge, even with adequate anchoring techniques, due to the high mechanical stress on components of occipital nerve stimulation (ONS) for headache disorders. When a lead displacement of an ONS implant is diagnosed, there are currently different approaches described for its management. Nevertheless current neuromodulation devices are designed like a continuum of components without any intermediate connector, and if a lead displacement is diagnosed, the solution is the complete removal of the electrode from its placement, and its repositioning through an ex-novo procedure. The described technique can allow ONS leads to be revised while minimizing the need to reopen incisions over the IPG, thus improving patients’ intraoperative and postoperative discomfort, shortening surgical time and medical costs, reasonably reducing the incidence of infective postoperative complications.
Research funding: None.
Author contributions: All authors contributed in some part to the design, and drafting of the manuscript. Jose De Andres and Giuseppe Luca Formicola drafted and initiated the article, and prepared the manuscript draft with important intellectual contributions by Ruben Rubio-Haro and Carmen De Andres-Serrano. All authors contributed to the revision and approved the submitted version of the manuscript.
Competing interests: None.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The local Institutional Review Board deemed the study exempt from review.
1. Lambru, G, Matharu, MS. Occipital nerve stimulation in primary headache syndromes. Therapeut Adv Neurol Disord 2012;5:57–67. https://doi.org/10.1177/1756285611420903.Search in Google Scholar
2. Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, et al.. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010 [published correction appears in Lancet [published correction appears in Lancet. 2013 Feb 23;381(9867):628. AlMazroa, Mohammad A [added]; Memish, Ziad A [added]]. Lancet 2012;380:2163–96. https://doi.org/10.1016/S0140-6736(12)61729-2.Search in Google Scholar
3. Steiner, TJ, Stovner, LJ, Katsarava, Z, Lainez, JM, Lampl, C, Lantéri-Minet, M, et al.. The impact of headache in Europe: principal results of the Eurolight project. J Headache Pain 2014;15:31. https://doi.org/10.1186/1129-2377-15-31.Search in Google Scholar PubMed PubMed Central
4. Castillo, J, Muñoz, P, Guitera, V, Pascual, J. Epidemiology of chronic daily headache in the general population. Headache 1999;39:190–6. https://doi.org/10.1046/j.1526-4610.1999.3903190.x.Search in Google Scholar PubMed
5. Robbins, MS, Lipton, RB. The epidemiology of primary headache disorders. Semin Neurol 2010;30:107–19. https://doi.org/10.1055/s-0030-1249220.Search in Google Scholar PubMed
6. Gaul, C, Finken, J, Biermann, J, Mostardt, S, Diener, HC, Müller, O, et al.. Treatment costs and indirect costs of cluster headache: a health economics analysis. Cephalalgia 2011;31:1664–72. https://doi.org/10.1177/0333102411425866.Search in Google Scholar PubMed
7. Wang, SJ, Wang, PJ, Fuh, JL, Peng, KP, Ng, K. Comparisons of disability, quality of life, and resource use between chronic and episodic migraineurs: a clinic-based study in Taiwan. Cephalalgia 2013;33:171–81. https://doi.org/10.1177/0333102412468668.Search in Google Scholar PubMed
8. Hu, XH, Markson, LE, Lipton, RB, Stewart, WF, Berger, ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med 1999;159:813–8. https://doi.org/10.1001/archinte.159.8.813.Search in Google Scholar PubMed
9. Mathers, CD, Bernard, C, Iburg, KM, Inoue, M, Fat, DM, Shibuya, K, et al.. The global burden of disease in 2002: data sources, methods and results. Global programme on evidence for health policy discussion paper no. 54, (revised 2004).Search in Google Scholar
10. Linde, M, Gustavsson, A, Stovner, LJ, Steiner, TJ, Barré, J, Katsarava, Z, et al.. The cost of headache disorders in Europe: the Eurolight project. Eur J Neurol 2012;19:703–11. https://doi.org/10.1111/j.1468-1331.2011.03612.x.Search in Google Scholar PubMed
11. Darbà, J, Marsà, A. Analysis of the management and costs of headache disorders in Spain during the period 2011–2016: a retrospective multicentre observational study. BMJ Open 2020;10:e034926. https://doi.org/10.1136/bmjopen-2019-034926.Search in Google Scholar PubMed PubMed Central
12. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia 2004;24(1 Suppl):9–160.Search in Google Scholar
13. Diener, HC, Holle, D, Solbach, K, Gaul, C. Medication-overuse headache: risk factors, pathophysiology and management. Nat Rev Neurol 2016;12:575–83. https://doi.org/10.1038/nrneurol.2016.124.Search in Google Scholar PubMed
14. Lionetto, L, Negro, A, Palmisani, S, Gentile, G, Fiore, MRD, Mercieri, M, et al.. Emerging treatment for chronic migraine and refractory chronic migraine. Expet Opin Emerg Drugs 2012;17:393–406. https://doi.org/10.1517/14728214.2012.709846.Search in Google Scholar PubMed
15. Black, DF, Dodick, DW. Two cases of medically and surgically intractable SUNCT: a reason for caution and an argument for a central mechanism. Cephalalgia 2002;22:201–4. https://doi.org/10.1046/j.1468-2982.2002.00348.x.Search in Google Scholar PubMed
16. Donnet, A, Valade, D, Régis, J. Gamma knife treatment for refractory cluster headache: prospective open trial. J Neurol Neurosurg Psychiatry 2005;76:218–21. https://doi.org/10.1136/jnnp.2004.041202.Search in Google Scholar PubMed PubMed Central
17. Jarrar, RG, Black, DF, Dodick, DW, Davis, DH. Outcome of trigeminal nerve section in the treatment of chronic cluster headache. Neurology 2003;60:1360–2. https://doi.org/10.1212/01.wnl.0000055902.23139.16.Search in Google Scholar PubMed
18. Matharu, MS, Goadsby, PJ. Persistence of attacks of cluster headache after trigeminal nerve root section. Brain 2002;125:976–84. https://doi.org/10.1093/brain/awf118.Search in Google Scholar PubMed
19. Wormald, JCR, Luck, J, Athwal, B, Muelhberger, T, Mosahebi, A. Surgical intervention for chronic migraine headache: a systematic review. JPRAS Open 2019;20:1–18. https://doi.org/10.1016/j.jpra.2019.01.002.Search in Google Scholar PubMed PubMed Central
20. Pedersen, JL, Barloese, M, Jensen, RH. Neurostimulation in cluster headache: a review of current progress. Cephalalgia 2013;33:1179–93. https://doi.org/10.1177/0333102413489040.Search in Google Scholar PubMed
21. Martelletti, P, Jensen, RH, Antal, A, Arcioni, R, Brighina, F, de Tommaso, M, et al.. Neuromodulation of chronic headaches: position statement from the European Headache Federation. J Headache Pain 2013;14:86. https://doi.org/10.1186/1129-2377-14-86.Search in Google Scholar PubMed PubMed Central
22. Schwedt, TJ, Dodick, DW, Hentz, J, Trentman, TL, Zimmerman, RS. Occipital nerve stimulation for chronic headache--long-term safety and efficacy. Cephalalgia 2007;27:153–7. https://doi.org/10.1111/j.1468-2982.2007.01272.x.Search in Google Scholar PubMed
23. Jasper, J, Hayek, S. Systematic review: implanted occipital nerve stimulators. Pain Physician 2008;11:187–200.10.36076/ppj.2008/11/187Search in Google Scholar
24. Johnstone, CS, Sundaraj, R. Occipital nerve stimulation for the treatment of occipital neuralgia-eight case studies. Neuromodulation 2006;9:41–7. https://doi.org/10.1111/j.1525-1403.2006.00041.x.Search in Google Scholar PubMed
25. Eldabe, S, Buchser, E, Duarte, RV. Complications of spinal cord stimulation and peripheral nerve stimulation techniques: a review of the literature. Pain Med 2016;17:325–36. https://doi.org/10.1093/pm/pnv025.Search in Google Scholar PubMed
26. Hayek, SM, Jasper, JF, Deer, TR, Narouze, SN. Occipital neurostimulation-induced muscle spasms: implications for lead placement. Pain Physician 2009;12:867–76.10.36076/ppj.2009/12/867Search in Google Scholar
27. Zimmerman, RS, Rosenfeld, DM, Freeman, JA, Rebecca, AM, Trentman, TL. Revision of occipital nerve stimulator leads: technical note of two techniques. Neuromodulation 2012;15:387–91. https://doi.org/10.1111/j.1525-1403.2011.00413.x.Search in Google Scholar PubMed
28. Shaw, A, Mohyeldin, A, Zibly, Z, Ikeda, D, Deogaonkar, M. Novel tunneling system for implantation of percutaneous nerve field stimulator electrodes: a technical note. Neuromodulation 2015;18:313–6. https://doi.org/10.1111/ner.12224.Search in Google Scholar PubMed
29. Zhou, L, Abad, M, Ashkenazi, A, Hud-Shakoor, ZR. Poster 264: occipital and supraorbital nerve stimulation for refractory cervicogenic headache – a comparative study. Pm&R 2010;2:S119. https://doi.org/10.1016/j.pmrj.2010.07.298.Search in Google Scholar
30. Rodrigo-Royo, MD, Azcona, JM, Quero, J, Lorente, MC, Acín, P, Azcona, J. Peripheral neurostimulation in the management of cervicogenic headache: four case reports. Neuromodulation 2005;8:241–8. https://doi.org/10.1111/j.1525-1403.2005.00032.x.Search in Google Scholar PubMed
31. Kapural, L, Mekhail, N, Hayek, SM, Stanton-Hicks, M, Malak, O. Occipital nerve electrical stimulation via the midline approach and subcutaneous surgical leads for treatment of severe occipital neuralgia: a pilot study. Anesth Analg 2005;101:171–4. https://doi.org/10.1213/01.ane.0000156207.73396.8e.Search in Google Scholar
32. Palmisani, S, Al-Kaisy, A, Arcioni, R, Smith, T, Negro, A, Lambru, G, et al.. A six year retrospective review of occipital nerve stimulation practice--controversies and challenges of an emerging technique for treating refractory headache syndromes. J Headache Pain 2013;14:67. https://doi.org/10.1186/1129-2377-14-67.Search in Google Scholar PubMed PubMed Central
33. Weiner, RL, Reed, KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation 1999;2:217–21. https://doi.org/10.1046/j.1525-1403.1999.00217.x.Search in Google Scholar PubMed
34. De Andres, J, Monsalve-Dolz, V, Fabregat-Cid, G, Villanueva-Perez, V, Harutyunyan, A, Asensio-Samper, JM, et al.. Prospective, randomized blind effect-on-outcome study of conventional vs. high-frequency spinal cord stimulation in patients with pain and disability due to failed back surgery syndrome. Pain Med 2017;18:2401–21. https://doi.org/10.1093/pm/pnx241.Search in Google Scholar PubMed
35. Kapural, L, Yu, C, Doust, MW, Gliner, BE, Vallejo, R, Sitzman, BT, et al.. Novel 10-kHz high-frequency therapy (HF10 therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: the SENZA-RCT randomized controlled trial. Anesthesiology 2015;123:851–60. https://doi.org/10.1097/aln.0000000000000774.Search in Google Scholar
36. Thomson, SJ, Tavakkolizadeh, M, Love-Jones, S, Patel, NK, Gu, JW, Bains, A, et al.. Effects of rate on analgesia in kilohertz frequency spinal cord stimulation: results of the PROCO randomized controlled trial. Neuromodulation 2018;21:67–76. https://doi.org/10.1111/ner.12746.Search in Google Scholar PubMed PubMed Central
37. Deer, T, Slavin, KV, Amirdelfan, K, North, RB, Burton, AW, Yearwood, TL, et al.. Success using neuromodulation with BURST (SUNBURST) study: results from a prospective, randomized controlled trial using a novel burst waveform. Neuromodulation 2018;21:56–66. https://doi.org/10.1111/ner.12698.Search in Google Scholar PubMed
38. Schu, S, Slotty, PJ, Bara, G, von Knop, M, Edgar, D, Vesper, J. A prospective, randomised, double-blind, placebo-controlled study to examine the effectiveness of burst spinal cord stimulation patterns for the treatment of failed back surgery syndrome. Neuromodulation 2014;17:443–50. https://doi.org/10.1111/ner.12197.Search in Google Scholar PubMed
39. Trentman, TL, Zimmerman, RS. Occipital nerve stimulation: technical and surgical aspects of implantation. Headache 2008;48:319–27. https://doi.org/10.1111/j.1526-4610.2007.01023.x.Search in Google Scholar PubMed
40. Craig, JAJr, Fisicaro, MD, Zhou, L. Revision of a superficially migrated percutaneous occipital nerve stimulator electrode using a minimally invasive technique. Neuromodulation 2009;12:250–3. https://doi.org/10.1111/j.1525-1403.2009.00223.x.Search in Google Scholar PubMed
41. Gofeld, M. Anchoring of suboccipital lead: case report and technical note. Pain Pract 2004;4:307–9. https://doi.org/10.1111/j.1533-2500.2004.04407.x.Search in Google Scholar PubMed
© 2020 Walter de Gruyter GmbH, Berlin/Boston