Spinal Cord Stimulation: Occipital Nerves

Occipital nerve stimulation is a simple, effective and practical treatment for disabling posterior headaches. It can break the downward spiral of opioid dependence, missed work, strained family relationships and social isolation, which so often destroys the lives of these poor patients.

Occipital nerve stimulation usually in combination with cervical field stimulation is an amazingly effective therapy for refractory cervicogenic headaches. It provides neuromodulatory relief at a time when ablative and pharmacological therapies have already failed. Patients who have been dependent on long-term narcotic and barbiturate therapy have been successfully weaned off of their medication and returned to normal lifestyles.

 

A major advantage of occipital nerve stimulations is that it is a therapy that tends to become more and more effective, rather than less and less effective over time. Long-term studies using functional MRI techniques have demonstrated progressive normalization of brain chemistry in the area of the limbic system with between 6 weeks and 6 months of occipital stimulation.

 

In the most common situation a pair of subcutaneous leads are placed in the scalp roughly parallel to the course of the greater and lesser occipital nerves. If posterior neck pain is a prominent symptom two additional leads are placed in the subcutaneous tissue of the neck, roughly parallel to the longus coli muscles in the distribution of the cervical median branches. The high rate of concordance with long-term implanted therapy makes a trial of stimulation an extremely attractive option when all else has failed.

 

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