title: High-cervical spinal cord stimulation for medically intractable chronic migraine.
abstract: OBJECTIVE
  High-cervical spinal cord stimulation (SCS) is a promising neurostimulation method for the control of chronic pain, including chronic cluster headache. The effects of high-cervical SCS in patients with intractable chronic migraine pain are unknown.
  
  
  METHODS
  This study is a retrospective survey of a cohort of 17 consecutive patients with medically intractable chronic migraine pain implanted with a high-cervical SCS device between 2007 and 2011.
  
  
  RESULTS
  After a median of 15 months (range 2-48) since implantation, mean pain intensity was significantly reduced by 60% (p < 0.0001), with 71% of the patients experiencing a decrease of 50% or more. The median number of days with migraine decreased from 28 (range 12-28) to 9.0 (range 0-28) days (p = 0.0313). Quality of life was significantly improved (p = 0.0006), and the proportion of patients not requiring pain medication increased from 0.0% to 37.5% (p = 0.0313). Use of pharmacological and nonpharmacological treatments of migraine was decreased. Working capacity was not significantly improved. Complications were infrequent: three infections (13.0% of all implanted) and three lead dislocations (17.6% of all included).
  
  
  CONCLUSIONS
  In patients with intractable chronic migraine treated with high-cervical SCS, pain and quality of life significantly improved, warranting further research.
authors.affiliation: Department of Internal Medicine and Pain Clinic, SeeSpital, Horgen, Switzerland.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: De Agostino
authors.affiliation: Department of Internal Medicine and Pain Clinic, SeeSpital, Horgen, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Federspiel
authors.affiliation: Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland.
authors.forename: Evaldas
authors.initials: E
authors.lastname: Cesnulis
authors.affiliation: ANNR RehaClinic, Kantonsspital Baden, CH-5404, Baden, Switzerland.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Sandor
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002574:Cervical Vertebrae; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010147:Pain Measurement; D011788:Quality of Life; D013116:Spinal Cord / Q000502:physiology*; D062187:Spinal Cord Stimulation / Q000379:methods*; D014938:Work Capacity Evaluation; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Chronic migraine; epidural spinal cord stimulation; headache; high-cervical spinal cord stimulation; neurostimulation