Retrograde Placement of High Cervical Electrodes: A Technical Refinement and Case Series

Neuromodulation. 2018 Dec;21(8):755-761. doi: 10.1111/ner.12770. Epub 2018 Mar 22.

Abstract

Introduction: Cervical cord stimulation is used in the treatment of chronic (neuropathic) pain syndromes refractory to conservative treatments. Several authors describe different techniques for the placement of cervical electrodes. Electrodes can be placed retrogade [Correction added on 03 April 2018 after first online publication: the word "plased" has been changed to "placed".]. In this article, we describe a refinement on how to dissect the dorsal meningo-vertebral ligaments to decrease the risk of complications.

Patients and methods: Twenty-eight patients received a permanent cervical spinal cord stimulator. A C0-C1 retrograde insertion was performed with careful dissection of the meningo-vertebral ligaments. Complications were registered during the follow-up (mean 44.6 months [SD = 43, range 1-162 months]).

Results: Six complications were observed 93% of the patients reported a significant reduction in pain.

Conclusions: We describe an additional surgical detail for the known procedure for retrograde placement of high cervical plate electrodes. This surgical detail might result in a lower risk of complications. We present a case series of 28 patients to support this hypothesis.

Keywords: Cervical cord stimulation; cervical pain; chronic pain; complications; technical report; upper limb pain.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae
  • Chronic Pain / therapy
  • Electrodes
  • Electrodes, Implanted* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuralgia / therapy*
  • Spinal Cord Stimulation / adverse effects
  • Spinal Cord Stimulation / methods*