Ghaemi Kazem, Capelle Hans-Holger, Kinfe Thomas M, Krauss Joachim K
Department of Neurosurgery, University of Medical Science, Birjand, Iran.
Stereotact Funct Neurosurg. 2008;86(6):391-3. doi: 10.1159/000175802. Epub 2008 Nov 25.
Occipital nerve stimulation is being used for various pain syndromes. Here, we expand its use for the treatment of refractory occipital pain after occipitocervical fusion.
We describe a case of occipital neuralgia in a 60-year-old man following posterior occipitocervical fusion. The maximum pain intensity was rated 9/10 on the visual analogue scale (VAS). Since pain proved to be refractory to analgetic medication, two quadripolar electrodes (Resume II, Medtronic) were implanted in the occipital region to stimulate the occipital nerve bilaterally. The patient experienced a dramatic response during test stimulation for 10 days with externalized electrodes, and a pacemaker (Synergy, Medtronic) was connected to the electrodes. While on chronic stimulation (bipolar 6 V, 210 mus, 130 Hz) improvement of pain was maintained, reflected by a decrease in the VAS score to 1/10 at 12 months of follow-up.
Occipital nerve stimulation for medical refractory occipital neuralgia after occipitocervical fusion is an effective method expanding the indications for its use.
枕神经刺激正被用于各种疼痛综合征。在此，我们拓展其用于治疗枕颈融合术后难治性枕部疼痛。
我们描述了一例60岁男性在枕颈后路融合术后发生枕神经痛的病例。疼痛最大强度在视觉模拟量表（VAS）上评为9/10。由于事实证明镇痛药物对疼痛无效，在枕部区域植入了两个四极电极（美敦力Resume II）以双侧刺激枕神经。患者在使用外置电极进行10天的测试刺激期间有显著反应，并将一个起搏器（美敦力Synergy）连接到电极上。在慢性刺激（双极6V，210微秒，130赫兹）期间，疼痛持续改善，在随访12个月时VAS评分降至1/10即反映了这一点。
枕神经刺激用于治疗枕颈融合术后药物难治性枕神经痛是一种有效的方法，拓展了其应用指征。
