6533b852fe1ef96bd12ab4ef

RESEARCH PRODUCT

Updated management of occipital nerve stimulator lead migration: case report of a technical challenge

Giuseppe Luca FormicolaRuben Rubio-haroCarmen De Andres-serranoJose De Andres

subject

medicine.medical_specialtybusiness.industryCranial nervesmedicine.diseaseNeuromodulation (medicine)Surgery03 medical and health sciences0302 clinical medicineAnesthesiology and Pain Medicine030202 anesthesiologyOccipital neuralgiaCervicogenic headachemedicineDisplacement (orthopedic surgery)Occipital nerve stimulationNeurology (clinical)ImplantbusinessLead (electronics)030217 neurology & neurosurgery

description

Abstract 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.

https://doi.org/10.1515/sjpain-2020-0135