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J Neurol Surg A Cent Eur Neurosurg 2016; 77(05): 441-446
DOI: 10.1055/s-0035-1563555
Surgical Technique
Georg Thieme Verlag KG Stuttgart · New York

A Simple Technique for Surgical Placement of Occipital Nerve Stimulators without Anchoring the Lead

Mark Plazier
1   Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
,
Tim Van Camp
2   Department of Neurosurgery/Brai2n, St-Augustinus, Antwerp, Belgium
,
Tomas Mevnosky
1   Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
,
Jan Ost
2   Department of Neurosurgery/Brai2n, St-Augustinus, Antwerp, Belgium
,
Dirk De Ridder
3   Department of Neurosurgery, University of Otago, Dunedin, New Zealand
,
Sven Vanneste
4   Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, United States
› Author Affiliations
Further Information

Publication History

05 June 2015

03 July 2015

Publication Date:
07 October 2015 (online)

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Abstract

Introduction Greater occipital nerve stimulation is applied in the treatment of occipital neuralgia, headache, and fibromyalgia. Multiple techniques have been described along with their subsequent complications. The most frequent complications are related to lead migration, infection, and undesired stimulation effects. Revision surgery occurs in up to 60% of the cases.

Patients and Methods A total of 92 implantations, 51 trials (6–10 weeks), and 41 permanent implantations (follow-up: 36–72 months) were performed in a single center using a simple technique without an anchoring device. The electrode is tunneled at a 45-degree angle to prevent migration. Complications and additional surgeries were recorded during the follow-up period.

Results All patients had bilateral greater occipital nerve stimulation. A total of 16 complications (17.4%) occurred. Seven patients (7.6%) underwent additional surgery. The major complication was infection; lead migration made up only 3.3% of the complications.

Conclusions We present a simple technique without the use of an anchoring device that is feasible in achieving bilateral occipital nerve stimulation and decreases the complications, especially lead migration.

Keywords

occipital nerve stimulation - technique - migration - anchoring - sharp angle
 

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