Upper Cervical Spinal Cord Stimulation as an Alternative Treatment in Trigeminal Neuropathy.
OBJECTIVE
To describe the indications and outcomes of upper cervical cord stimulation in trigeminal neuropathy.


METHODS
A consecutive single-center series of patients was retrospectively reviewed. It included 12 patients with trigeminal neuropathy treated with upper cervical spinal cord stimulation. Clinical features, complications, and outcomes were reviewed.


RESULTS
All patients had a successful trial before the definitive implantation of a spinal cord stimulator at the level of the craniocervical junction. The mean follow-up period was 4.4 years (range, 0.3-21.1 years). The average coverage in the pain zone was 72% and the median baseline, trial, and postoperative numeric rating scale (NRS) was 7, 3, and 3, respectively. When compared with the baseline, the mean reduction achieved in the postoperative average numeric rating scale was 4 points, accounting for a 57.1% pain reduction. The long-term failure rate was 25%.


CONCLUSIONS
Despite there being enough evidence to consider upper cervical spinal cord stimulation as an effective treatment for patients with neuropathic trigeminal pain, a randomized controlled trial is needed to fully assess its indications and outcomes and compare it with other therapeutic approaches.
['Velásquez|Carlos|C|', 'Tambirajoo|Kantharuby|K|', 'Franceschini|Paulo|P|', 'Eldridge|Paul R|PR|', 'Farah|Jibril Osman|JO|']
D000328:Adult D000368:Aged D059350:Chronic Pain D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009437:Neuralgia D010147:Pain Measurement D012189:Retrospective Studies D062187:Spinal Cord Stimulation D016896:Treatment Outcome D020433:Trigeminal Nerve Diseases
Spinal cord stimulation Trigeminal neuropathy Facial pain Neuromodulation