Occipital neuromodulation: ultrasound guidance for peripheral nerve stimulator implantation.
Pain Pract
; 10(6): 580-5, 2010.
Article
em En
| MEDLINE
| ID: mdl-20492581
ABSTRACT
We report a case of chronic left-sided occipital neuralgia in a 21-year old female patient. The patient in question suffered from chronic greater occipital neuralgia for a duration of many years, which had been refractory to other conservative medical management strategies. Blockade of the greater occipital nerve with local anesthetic was consistently useful in attenuating the patient's pain, though the effects were always short lived. Consequently, a successful trial of greater occipital nerve stimulation was undertaken. Compared with spinal cord stimulation, peripheral nerve stimulation devices are often more difficult to precisely place given limited ability to visualize soft tissues with traditional fluoroscopic guidance. Additionally, there are anatomic subtleties relevant to the greater occipital nerve that potentially complicate stimulator lead placement, both from the standpoint of optimal neuromodulation efficacy and maximum safety. Ultrasound technology is a maturing imaging modality that allows soft tissue visualization and is consequently useful in addressing each of these aforementioned concerns. The specific use of high-frequency ultrasound guidance for this procedure simplified the initial device placement and allowed proper visualization of soft tissue structures, which facilitates precise device deployment. Additionally, the ability to identify relevant vascular structures may further increase the safety of stimulator lead placement. The potential advantages of ultrasound-augmented procedural techniques, specifically as they pertain to occipital stimulator lead placement, are discussed with particular emphasis on potentially decreasing intraoperative and postoperative complications while optimizing stimulation efficacy.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Nervos Espinhais
/
Terapia por Estimulação Elétrica
/
Neuralgia
/
Osso Occipital
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
Pain Pract
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos