Abstract
Background: The role for spinal cord stimulation (SCS) in the management of chronic spinal cord formsof pain involving cervical dermatomes or the cervicomedullary junction (CMJ) for facial pain remainslargely uncharted.Objective: To review outcomes with cervical and CMJ SCS performed by a single surgeon, with particularemphasis on complications and efficacy.; Methods: All patients that underwent cervical or CMJ SCS by the lead author were identified and follow-upobtained by telephone questionnaires. Patient demographics, surgical details, outcomes and complica-tions for all patients identified were critically reviewed.; Results: Of 121 patients identified that underwent at least trial SCS, 100 underwent permanent leadimplantation. Indications for cervical SCS included brachial plexus lesions (8), complex regional painsyndrome (33), degenerative disc disease (4), failed neck surgery syndrome (23), chronic radiculopathy(6) and post-herpetic neuralgia (PHN) (1); for CMJ SCS, indications included trigeminal deafferetiationpain (10), trigeminal neuropathic pain (4), PHN (4) and occipital neuralgia (7). Pain relief was greateralong the extremities than axially, and less in the occipital area than in the head or face. Mean painreduction averaged 56.6% at a mean follow-up of 4.2 years. Of 24 revision surgeries required, 8 were forpresumed lead migration or fracture. Complications included 4 CSF leaks, 5 wound infections, and 4 casesof persistent numbness or pain. Pain relief lasted an average of 3.6 years.; Conclusion: Cervical and CMJ SCS are safe and efficacious and may provide greater relief along the upperextremities than axially, and in the head rather than in the occipital region© 2014 Elsevier B.V. © 2014 Elsevier B.V. All rights reserved.