title: Retrograde C0-C1 insertion of cervical plate electrode for chronic intractable neck and arm pain.
abstract: OBJECTIVE
  Spinal cord stimulation is an effective treatment for chronic neuropathic pain after spinal surgery. In addition to the most common placement of electrodes at the thoracic level for low back and leg pain, electrodes can also be placed on a cervical level in patients with chronic neck and upper limb pain. Surgical insertion of plate electrodes via an orthodromal direction requires a partial laminectomy. Therefore, the authors describe a surgical technique using retrograde insertion of a plate electrode to avoid laminectomy.
  
  
  METHODS
  Six patients with uncontrolled neck and upper limb pain despite optimal analgesic medication were treated with a surgical electrode placed at the C1-C2 level via a retrograde placement technique without laminectomy.
  
  
  RESULTS
  All patients received stimulation paresthesias at the desired regions and reported significant pain reduction in the neck and arm regions.
  
  
  CONCLUSIONS
  This retrograde placement of plate electrodes enables cervical lordosis to be overcome and results in adequate stimulation of the upper cervical region, which is mandatory to reduce neck and shoulder pain without laminectomy.
authors: Department of Neurosurgery, UZ Brussel, Brussels, Belgium. mtmoens@gmail.com
authors: Maarten
authors: M
authors: Moens
authors: Ann
authors: A
authors: De Smedt
authors: Raf
authors: R
authors: Brouns
authors: Herbert
authors: H
authors: Spapen
authors: Steven
authors: S
authors: Droogmans
authors: Johnny
authors: J
authors: Duerinck
authors: Jan
authors: J
authors: D'Haese
authors: Jean
authors: J
authors: D'Haens
authors: Bart
authors: B
authors: Nuttin
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000768:Anesthesia, General; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001132:Arm; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D019547:Neck Pain / Q000188:drug therapy / Q000628:therapy*; D009437:Neuralgia / Q000188:drug therapy / Q000628:therapy*; D013116:Spinal Cord / Q000502:physiology*; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen