背景:枕神经痛是一种慢性疼痛综合征,拍摄枕骨神经分布的疼痛。虽然相对罕见,它与极度衰弱的症状有关,严重影响患者的生活质量。此外,由于症状对传统治疗难以治疗,包括药物和程序干预。先前的一些案例研究已经确定了使用枕骨神经刺激来治疗枕骨神经痛。
目的:通过回顾性回顾一个相对较大的患者队列(29例患者)的枕神经刺激结果,对文献进行扩展。
方法:回顾性回顾了2012年至2017年在单一机构和一名神经外科医生中接受枕神经刺激治疗枕神经痛的29例患者。
结果:在这29名患者中,5是维修或更换以前的系统,4没有从试验刺激中获益,20例患者的刺激试验阶段获益,并继续进行完全植入.在这20名患者中,即使有失败的手术和药物治疗的历史,总体成功率为85%。术前平均10点疼痛评分从7.4±1.7降至2.9±1.7。然而,和任何周围神经刺激手术一样,有并发症(4例),包括感染,硬件侵蚀,失去效果,和铅迁移,需要修订或系统删除。
结论:尽管有并发症,结果表明,总的来说,枕骨神经刺激治疗难治性枕骨神经痛是一种安全有效的方法,应在枕骨神经痛的神经外科治疗中使用。
BACKGROUND: Occipital neuralgia is a chronic pain syndrome characterized by sharp, shooting pains in the distribution of the occipital nerves. Although relatively rare, it associated with extremely debilitating symptoms that drastically affect a patient\'s quality of life. Furthermore, it is extremely difficult to treat as the symptoms are refractory to traditional treatments, including pharmacologic and procedural interventions. A few previous
case studies have established the use of a neurostimulation of the occipital nerves to treat occipital neuralgia.
OBJECTIVE: The following expands on that literature by retrospectively reviewing the results of occipital nerve stimulation in a relatively large patient cohort (29 patients).
METHODS: A retrospective review of 29 patients undergoing occipital nerve stimulation for occipital neuralgia from 2012 to 2017 at a single institution with a single neurosurgeon.
RESULTS: Of those 29 patients, 5 were repair or replacement of previous systems, 4 did not have benefit from trial stimulation, and 20 saw benefit to their trial stage of stimulation and went on to full implantation. Of those 20 patients, even with a history of failed procedures and pharmacological therapies, there was an overall success rate of 85%. The average preoperative 10-point pain score dropped from 7.4 ± 1.7 to a postoperative score of 2.9 ± 1.7. However, as with any peripheral nerve stimulation procedure, there were complications (4 patients), including infection, hardware erosion, loss of effect, and lead migration, which required revision or system removal.
CONCLUSIONS: Despite complications, the results suggest, overall, that occipital nerve stimulation is a safe and effective procedure for refractory occipital neuralgia and should be in the neurosurgical repertoire for occipital neuralgia treatment.